Infectious Bite | Malaria

World Malaria Day

2011-04-25T10:07:00.001-04:00

“In a rural hospital in Ethiopia that cares for the poor, a fragile young girl called Zakhiya has recovered recently from severe malaria. In the six short years of her life, Zakhiya has battled a number of infectious diseases. Her struggle will probably continue throughout her childhood. But Zakhiya is fortunate: she has fought off malaria -- this time.”

25 April 2011 is World Malaria Day. Malaria kills over 800,000 people each year, but malaria prevention efforts are helping cut down this number. “An expansion of malaria control programs between 2008 and 2010 has resulted in the distribution of enough [ insecticide-treated mosquito nets (ITNs) ] to protect more than 578 million people in sub-Saharan Africa, according to the World Malaria Report 2010, and indoor spraying has protected 75 million people, or 10% of the population at risk in 2009.”

During the past 10 years, malaria prevention and treatment efforts have saved an estimated 750,000 children in 34 African countries. Distribution of nets, indoor pesticide spraying, and use of effective medications are the best adversaries to the malaria parasite and the mosquitoes that carry it.

A decade ago, Zanzibar recorded over 18,000 cases of malaria. Today, it is virtually absent from the archipelago. “In 2009, Morocco and Turkmenistan were certified by the World Health Organization (WHO) as having eliminated malaria and the WHO European Region reported no cases of Plasmodium falciparum malaria for the first time.”

“These successes have been a collaborative effort of government, multilateral and non-government organizations and the private sector. But much of the leadership and funding has come from the U.S. government, through the President's Malaria Initiative, the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Bill& Melinda Gates Foundation. These donors have helped drive an 18-fold increase in malaria funding between 2003 and 2010.”

We can celebrate this World Malaria Day, because efforts to stop malaria are proving themselves successful. “But malaria remains a deadly killer, threatening half the world's population and taking nearly 800,000 lives a year. Malaria strikes society's most vulnerable, especially children under the age of five -- 85 percent of malaria deaths fall into this group -- and pregnant women.”

Malaria also strikes at the economy. This “disease costs Africa US$12 billion in lost GDP every year and consumes 40 percent of all public health spending in malaria endemic countries in Africa, where lost productivity is estimated to reduce GDP by 1.3 percent per year. And malaria consumes up to one-quarter of household income in some countries.”

“One of the most difficult challenges” malaria presents “is to make novel health interventions affordable, accessible and available to those who need” them the most. “In this long war to eradicate malaria we are at a tipping point. Malaria has been eliminated or is close to elimination in several countries.” We cannot stop fighting.

“To stop efforts before the last parasite has been defeated is to lose the enormous gains already made.” Malaria spreads quickly. We must be faster. Every 45 seconds a child dies from malaria. Malaria eradication is within reach. With global effort we can make this deadly disease a thing of the past.

Source:
Sturchio, Jeffrey L.; David Reddy. "Malaria: Solid Success but No Time for Complacence". Huffpost Health. 23 April 2011.

Troublesome genes

2010-10-16T16:17:00.003-04:00

Artemisinin, a plant-based remedy, is one of the most effective drugs used to combat malaria. "In many countries where the [malaria] parasite has developed resistance to previously effective common treatments such as chloroquine, artemisinin remains the only effective treatment against the infection. However, malarial resistance to artemisinin appears to be developing, potentially creating problems in controlling malaria."

A recent study conducted "by scientists from the University of Edinburgh and the Universidade Nova de Lisboa, used emerging technology to scan the genetic fingerprint of drug resistant parasites that infect rodents. This technology allows rapid identification of genes that enable the parasite to withstand existing drug treatments", particularly the "gene that enables the parasite" to resist treatment with artemisinin.

Dr Paul Hunt, from the University of Edinburgh's School of Biological Sciences, said: "This knowledge from rodent malaria parasites opens up new directions that will allow this gene to be investigated in human malaria. This may help track the evolution of drug resistance and may eventually enable the design of alternative, effective drugs."

Sources:
Paul Hunt, Axel Martinelli, Katarzyna Modrzynska, Sofia Borges, Alison Creasey, Louise Rodrigues, Dario Beraldi, Laurence Loewe, Richard Fawcett, Sujai Kumar, Marian Thomson, Urmi Trivedi, Thomas D Otto, Arnab Pain, Mark Blaxter, Pedro Cravo. Experimental evolution, genetic analysis and genome re-sequencing reveal the mutation conferring artemisinin resistance in an isogenic lineage of malaria parasites. BMC Genomics, 2010; 11 (1): 499 DOI: 10.1186/1471-2164-11-499

University of Edinburgh (2010, October 12). Gene linked to drug resistance in malaria pinpointed. ScienceDaily. Retrieved October 16, 2010, from http://www.sciencedaily.com /releases/2010/10/101012101629.htm

Sweet incentives

2010-09-19T21:23:00.003-04:00

Incentives to develop treatments for "neglected diseases including malaria, tuberculosis and leishmanaisis" may encourage drug companies to focus more on potentially life-saving research and development, declares a U.S. business professor. The suggested incentive comes in the form of a "priority review voucher", which "would give a company accelerated regulatory review of one of its other drugs as a reward for developing a treatment for neglected disease".

Although these diseases affect more than 1 billion people, they occur most frequently in developing nations, providing little financial incentive for pharmaceutical companies to create and test new treatments.

Writing in the Sept. 11 issue of The Lancet, professor David Ridley of Duke University's Fuqua School of Business and Alfonso Calles-Sánchez, a patent expert with the Spanish Patent Office and former pharmaceutical policy maker at the European Commission, propose a European Union version of the priority review voucher system instituted in the United States in 2007.

Bill Gates explained an example of such incentives at the 2008 World Economic Forum in Davos. "If you develop a new drug for malaria, your profitable cholesterol-lowering drug could go on the market a year earlier...This priority review could be worth hundreds of millions of dollars [to the company]," Gates said.

In the U.S., the vouchers and other incentives are working. Firms and drug companies are motivated to begin clinical testing; although, these drugs may take several years to reach patients in need. Still, any forward movement in these fields is improvement. With continued encouragement, drug companies may enact the demise of malaria and other currently neglected diseases.

Do you have ideas or suggestions for other incentives that may encourage the eradication of malaria?

Sources:
David B Ridley, Alfonso Calles Sánchez. Introduction of European priority review vouchers to encourage development of new medicines for neglected diseases. The Lancet, 2010; 376 (9744): 922-927 DOI: 10.1016/S0140-6736(10)60669-1

Duke University (2010, September 9). European Union could create incentive for new drug treatments, experts propose. ScienceDaily. Retrieved September 19, 2010, from http://www.sciencedaily.com /releases/2010/09/100909193359.htm

Image by Petar Marjanovic

A new treatment

2010-08-31T22:59:00.004-04:00

A new anti-malarial drug may soon progress to clinical trials. This new treatment "is made from simple organic molecules and will be cheaper to mass produce compared to existing therapies."

Malaria is widespread and deadly. Many of the nearly 250 million people who contract the malaria parasite each year do not have access or cannot afford adequate treatment. Drugs that are easy and cheap to produce and distribute may save many of the nearly one million lives that are lost each year due to malaria infection.

With the goal of easing the cost of malaria eradication on poor countries and individuals, the research "team at Liverpool" has "created a synthetic drug based on the chemical structure of artemisinin, an extract of a Chinese herb commonly used in malaria treatment. The new drug, which can be taken orally, is more potent than naturally derived artemisinin."

"Malaria affects the world's poorest countries and hospitals are unable to afford expensive treatments. The problem with current artemisinin-based therapies is their limited availability, poor oral absorption and high cost. We have created a new drug that is easily absorbed by the body, chemically stable and highly potent. It is made from very simple organic materials and therefore will be more cost-effective to mass produce than current therapies," says Professor Paul O'Neill.

Artemisinin is known to interact with a substance inside parasite-infected red blood cells, causing a chain of events that destroys malaria. The treatment, however, is difficult to mass produce and can be chemically unstable in the body. Scientists have now found a way of creating the most reactive part of artemisinin synthetically and fusing it with a cage-like structure made of organic molecules to make the drug more chemically stable. The stability of the chemical structure in the body makes the drug last longer, reducing the chance of the parasite reappearing.

Source:
University of Liverpool (2010, August 16). New drug treatment for malaria?. ScienceDaily. Retrieved August 31, 2010, from http://www.sciencedaily.com /releases/2010/08/100816095715.htm

Biological warfare

2010-08-22T21:44:00.002-04:00

Scientists from Johns Hopkins University are waging biological warfare against mosquitoes by using a "naturally occurring virus" that "may serve as a "late-life-acting" insecticide. The virus only affects adult mosquitoes, which "are responsible for the bulk of malaria transmission."

Malaria is a widespread and deadly disease that is transmitted by mosquitoes and kills approximately one million people each year. "Insecticides are one of the main strategies currently used to control malaria transmission[;] however, evolving resistance to such therapies continues to impact such efforts." Scientists now look to late-life-acting insecticides (LLAIs), which "selectively kill older mosquitoes that spread the disease, while younger mosquitoes survive just long enough to reproduce." In this way, LLAIs kill malaria transmitting mosquitoes without affecting the gene pool in a way that will stimulate the propagation of insecticide-resistant mosquitoes.

"Reproduction allows for relaxation of evolutionary pressures that select for resistance to the agent," say the researchers. "If resistance alleles exert fitness costs, there are theoretical scenarios under which resistance is not expected to evolve, leading some to provocatively term LLAIs as 'evolution-proof'."

Source:
American Society for Microbiology (2010, August 21). Virus may act as 'evolution-proof' biopesticide against malaria. ScienceDaily. Retrieved August 22, 2010, from http://www.sciencedaily.com /releases/2010/08/100820133238.htm

Ren et al. Potential for the Anopheles gambiae Densonucleosis Virus To Act as an "Evolution-Proof" Biopesticide. Journal of Virology, 2010; 84 (15): 7726 DOI: 10.1128/JVI.00631-10

Population at risk

2010-08-10T21:48:00.004-04:00

Nearly 3 billion people live at risk of infection with Plasmodium vivax, one of the most common varieties of the blood-borne malaria parasite. A global distribution map, "published August 3 in the open-access journal PLoS Neglected Tropical Diseases," estimates that 2.85 billion people live in areas and conditions that put them at risk for contracting deadly malaria.

Malaria is a parasite that infects humans and is transmitted through the bite of an anopheles mosquito. Every year 250-500 million cases of malaria are reported, many malaria cases end in death. In recent years, scientists, doctors, and health-care workers have made progress against malaria. Still, more information is needed to truly understand how effective treatments and preventative techniques are against malaria and where these techniques still need to be applied.

"The map, created as part of the Malaria Atlas Project (MAP), a multinational research collaboration funded mainly by the Wellcome Trust, reviews a host of information that challenges the dogma that P. vivax transmission is absent through large swathes of Africa and uses novel methods...to estimate global populations at risk."

Of the nearly "3 billion people exposed to some risk of P. vivax" malaria transmission in 2009, 91% live in Central and South East Asia. It is important to note that "more than half of those exposed to this risk live in areas where P. vivax malaria transmission is extremely low or unstable". In these areas, prospects of sustained malaria control and "elimination are relatively good".

The authors of this study used the most recently available P. vivax data from reported cases for all malaria-endemic countries and classified risk into three classes: malaria free, unstable, and stable. Risk areas were further refined, and some regions were eliminated based on temperature, aridity, and isolation. Some urban regions known to be malaria-free were also excluded from the at-risk population estimate.

"This study represents the first step in our efforts to provide the malaria control and research community with an evidence-based cartography of P. vivax malaria," says co-author Dr. Simon Hay of the University of Oxford. "We can now focus on trying to model the endemicity of the disease to provide more detailed global burden estimates, although this is complicated by the unusual biology of P. vivax."

Co-author Dr Carlos Guerra adds: "New evidence shows that P. vivax malaria is not as benign as was thought, and yet, as our study shows, remains the most widespread form of human malaria. Understanding where transmission of this parasite occurs at the global scale is fundamental in planning strategies for the control of this debilitating, and often lethal, disease."

Further information about the Malaria Atlas Project can be found at www.map.ox.ac.uk.

Sources:
Guerra CA, Howes RE, Patil AP, Gething PW, Van Boeckel TP, et al. The International Limits and Population at Risk of Plasmodium vivax Transmission in 2009. PLoS Neglected Tropical Diseases, 2010; 4 (8): e774 DOI: 10.1371/journal.pntd.0000774

Malaria Atlas Project [MAP]. www.map.ox.ac.uk. Retrieved August 10, 2010.

Public Library of Science (2010, August 4). New estimates of the global population at risk of Plasmodium vivax malaria. ScienceDaily. Retrieved August 10, 2010, from http://www.sciencedaily.com /releases/2010/08/100803174854.htm

Antibiotics prevent malaria

2010-07-23T21:53:00.003-04:00

Preventative malaria "treatment with affordable and safe antibiotics...has the potential to act as a 'needle-free' natural vaccine against malaria", according to a study published in the journal, Science Translation Medicine. This type of treatment "may likely provide an additional valuable tool for controlling and/or eliminating malaria in resource-poor settings."

During research, the multinational team "found that infection with malaria parasites during administration of preventative antibiotics developed a vaccine-like immunity against re-infection."

Approximately one million people die from malaria each year and nearly half of the world's population is at risk of contracting malaria, a mosquito-transmitted parasite. "Only an estimated 10 to 100 parasites per mosquito bite invade the liver where they replicate. About a week after infection, tens of thousands of parasites are released into the bloodstream where they are responsible for malaria's recurring fevers and cause life-threatening complications."

The proposed treatment attacks parasites "during their passage into the liver of the infected host. The "researchers showed that the antibiotics caused a cellular defect in malaria parasites...This action did not prevent parasite replication in the liver but blocked the malaria parasite's fatal conversion to the disease causing blood stage. The very late arrest of parasites in the liver allowed the immune system to mount a robust defense against subsequent infections." In this way, the body produces results that are comparable to vaccines that use weakened varieties of the parasite.

Further reading:
London School of Hygiene & Tropical Medicine (LSHTM) (2010, July 23). 'Needle-free' intervention as natural vaccine against malaria. ScienceDaily. Retrieved July 23, 2010, from http://www.sciencedaily.com /releases/2010/07/100723112711.htm

Outposts

2010-07-14T06:59:00.003-04:00

Ten newly funded projects focus on regions where malaria is currently endemic. After receiving "$14 million in first-year funding from the U.S. National Institute of Allergy and Infectious Diseases (NIAID), 10 new research centers are joining the fight to control and ultimately eliminate malaria worldwide."

Malaria parasites infect about 250 million people each year and cause nearly one million deaths annually. Regions that are most plagued by malaria include parts of Africa, Asia, the Pacific islands, and Latin America. These areas are where the NIAID research centers will do the most good.

"The regions include some of the focus countries of the President’s Malaria Initiative, an effort that since 2005 has worked to fight malaria in parts of the world most affected by the disease."

“One of our primary goals with these centers is to fund cutting-edge research in malaria-endemic areas that will keep up with the rapidly changing epidemiology of the disease,” said NIAID Director Anthony S. Fauci.

Although malaria has already been eliminated from many parts of the world, "40 percent of the world’s population still lives in areas where they are at risk of contracting the disease."

Scientists and medical professionals at these new centers hope to find a way to end malaria. "The centers seek to integrate clinical and field approaches with laboratory-based immunologic, molecular and genomic methods. They will adapt their research to changes in malaria epidemiology and emerging research needs as well as opportunities within specific regions."

Source:
"US Health Institute Funds 10 Global..." America.gov. 09 July 2010. http://www.america.gov/st/scitech-english/2010/July/20100709163404frnedloh0.4317896.html

Antioxidants

2010-07-09T06:58:00.002-04:00

Adding "antioxidant therapy to traditional antimalarial treatment may prevent long-lasting cognitive impairment in cerebral malaria", based on research from an experimental mouse model.

"Malaria, an infection caused by parasites that invade liver and red blood cells, is transmitted to humans by the female Anopheles mosquito. Malaria is one of the leading infectious diseases worldwide, affecting more than 400 million people and causing more than 2 million deaths each year, mainly among African children."

Cerebral malaria is a "potentially fatal neurologic complication of infection by the most-feared malarial parasite, Plasmodium falciparum." Cerebral malaria is known to cause life-long memory loss, learning impairment, and language and math deficits. Cognitive damage persists even after the malaria illness is cured.

"Cerebral malaria and its molecular mechanisms are under intense study, but the cognitive dysfunction that can persist in survivors in the aftermath of successful treatment has gone unrecognized until recently," says Guy A. Zimmerman M.D., professor and associate chair for research in the University of Utah School of Medicine's Department of Internal Medicine and a contributor to the study. "This complication may impose an enormous social and economic burden because of the number of people at risk for severe malaria worldwide. Our findings demonstrate that, by using experimental models of cerebral malaria in mice, we can explore mechanisms of cognitive damage and also examine potential treatments for reducing or preventing neurologic and cognitive impairment."

Scientists studied "the persistence of cognitive damage in mice with documented cerebral malaria after cure of the acute parasitic disease with chloroquine, an antimalarial therapy". Zimmerman and his colleagues "determined that impairment in memory skills was still present 30 days after the initial malaria infection. Cognitive deficits that persist for years after the episode of cerebral malaria have also been reported in 11 percent to 28 percent of children who survive the infection."

The researchers believe that "it is possible that the mechanisms for persistent cognitive deficits are independent of those that cause neurological injury and death during acute cerebral malaria". They have been able to "demonstrate that oxidative stress is present in the brains of mice infected with cerebral malaria."

Oxidative stress is an imbalance between the production of reactive oxygen-containing molecules. The imbalance "can damage cell structures and the body's ability to detoxify these molecules or repair the resulting damage."

The research group found that "treating mice with a combination of chloroquine" and antioxidant agents "at the first signs of cerebral malaria prevented both inflammatory and vascular changes in the tissues of the brain, as well as the development of persistent cognitive damage." Furthermore, the antioxidants did not diminish the efficacy of the antimalarial.

Although, antioxidants may not treat malaria directly, they may stave off one of the most dreaded results of enduring cerebral malaria.

Source:
University of Utah Health Sciences (2010, June 28). Antioxidants may help prevent malaria complicaton that leads to learning impairment. ScienceDaily. Retrieved July 9, 2010, from http://www.sciencedaily.com /releases/2010/06/100625131416.htm

Sponging up the mess

2010-06-30T16:08:00.003-04:00

"Healing powers for one of the world's deadliest diseases may lie within sponges, sea worms and other underwater creatures." Malaria, a blood-parasite transmitted by mosquitoes, kills nearly a million people each year and infects hundreds-of-thousands of humans. The battle against this deadly disease has forced scientists to look in unlikely places for a cure. Now, they're even looking in depths of the sea.

"University of Central Florida scientist Debopam Chakrabarti is analyzing more than 2,500 samples from marine organisms collected off deep sea near Florida's coast. Some of them could hold the key to developing drugs to fight malaria". Nothing has been proven yet, but Chakarabarti is optimistic. "One active sample" that he tested, "derived from a marine sponge, contained the compound Nortopsentin. Because of this compound's initial promise" at combating disease, Chakrabarti has "already filed an application for patent protection." With assistance from two graduate students, Chakrabarti has "conducted preliminary testing of more than 2,500 samples from the Harbor Branch collection. They conducted tests to evaluate growth inhibitory properties of these samples for malaria parasite growing inside human red blood cells in culture."

Chakrabarti's approach of looking to marine sources for disease treatment is not new. He follows in the footsteps of modern scientists and ancient medics.

In the meantime, Chakrabarti is concerned how the Gulf of Mexico's oil spill will affect his work. "He's also concerned...that the...oil spill may wipe out species that could hold healing properties for many deadly diseases."

"If we can find two or three good molecules that can be easily synthesized in a lab and that can prevent malaria, I'd be very happy," he said.

Source:
University of Central Florida (2010, June 28). Underwater sponges and worms may hold key to cure for malaria. ScienceDaily. Retrieved June 30, 2010, from http://www.sciencedaily.com /releases/2010/06/100628124601.htm

Yellow Fever

2010-06-13T17:31:00.001-04:00

“Malaria is one of the most pressing health crises of developing countries: in communities stricken by infection, attendance at work and school drops, and poverty deepens…There is no vaccine for malaria, which sickens almost a quarter of a billion people each year and kills a child every 30 seconds.” Scientists race to change those statistics, exploring various avenues for human vaccination and malaria eradication. Recently, “researchers at The Rockefeller University have genetically transformed the yellow fever vaccine to prime the immune system to fend off the mosquito borne parasites that cause the disease. The researchers found that the modified vaccine, along with a booster, provided mice with immunity to the deadly disease.”

“It has been known since the 1960s that” the sporozoite, one form of the malaria parasite “can wake up the immune system and help to protect against future infection.” Unfortunately, the only known “way to gather sporozoites…is to pluck them one-by-one from the salivary glands of irradiated, malaria-ridden mosquitoes. To provide immunity, the attenuated parasites must then be injected in high doses” or “delivered by the bites of hundreds of mosquitoes”, which is “a labor intensive approach not feasible for large-scale use.”

In an effort to find a better way to achieve the “benefits of sporozoite immunization”, scientists, led by Charles Rice, thought “that fighting infection with infection might be the key. They began experimenting with the attenuated yellow fever strain used in the yellow fever vaccine, known as YF17D, which has been used to successfully vaccinate more than 400 million people since 1937. Previous work in the Rice laboratory and by others had shown that this vaccine strain could be modified to include short sequences from other pathogens, including malaria.”

“Immunization of mice with the YF17D-CSP vaccine led to a measurable jump in immune activity against the malaria protein, but the single shot was not enough to protect the animals from infection with the mouse form of the malaria parasite.” The scientists added a booster shot, and discovered that “vaccination with YF17D-CSP plus the sporozoites protected 100 percent of the animals against infection.”

Sources:
Stoyanov et al. Immunogenicity and protective efficacy of a recombinant yellow fever vaccine against the murine malarial parasite Plasmodium yoelii. Vaccine, 2010; 28 (29): 4644 DOI: 10.1016/j.vaccine.2010.04.071

Rockefeller University (2010, June 11). Yellow fever vaccine modified to fight malaria. ScienceDaily. Retrieved June 13, 2010, from http://www.sciencedaily.com¬ /releases/2010/06/100611222839.htm

Malaria in Venezuela

2010-06-07T06:53:00.000-04:00

Miners, in search of gold and diamonds, fear a plague of malaria. “These workers have long caught the disease by venturing into forests where malaria-carrying mosquitoes live. Their strip-mines destroy patches of forest, leaving behind muddy pools and water contaminated with the mercury they use to separate gold from rock.”

“Malaria cases have doubled in Venezuela so far this year as health officials confront an epidemic in a vast southern region where wildcat gold miners are often infected in remote jungle camps.”

Last year, the country reported 10,758 malaria cases. Already this year, 21,601 cases have been recorded. Most patients “were diagnosed in southern Bolivar state, where government officials say there is an epidemic. The statistics, which are updated weekly and circulated among some health officials, cover the period running from the start of the year through May 22.”

“Public health officials attribute the rise in malaria cases in part to a government-led operation this year in which soldiers have evicted thousands of miners from their illegal strip-mines.”

This government initiative displaced miners, who sought refuge in towns. With them, they brought disease and spread malaria into areas that were previously clean.

Dr. Ana Gineth Morales, who heads the Bolivar state Public Health Institute, expected this surge in malaria cases. “It hasn't taken us by surprise," Morales asserts, reassuring interviewers that her agency had been fully prepared. The Public Health Institute is “efficient in diagnosing, detecting." Despite the increase in cases of malaria, few people have died.

But some critics say the malaria situation appears to be out of control.

"We expect malaria cases will keep increasing," said Dr. Angel Granados, of the Bolivar state Medical Association. Granados cites the recent rain and continual movement of miners as contributing causes. “Public health teams haven't been reaching many remote areas including indigenous communities to detect and treat cases,” Granados said.

Granados reminded officials that, earlier this year, one Yekuana Indian community “reported six deaths — including three children and three adults — that came after they suffered high fevers and appeared to be due to malaria. But he said state health officials ruled out malaria saying the deaths were due to other causes and did not include them in their tally.”

Source:
James, Ian. “Malaria epidemic hits southern Venezuela.” Associated Press. 5 June 2010.

Cerebral malaria

2010-06-02T23:08:00.002-04:00

“Scientists are making strides against cerebral malaria, a fatal form of malaria in children that can ravage the brain and is extremely difficult to treat.” Cerebral malaria causes inflammation in the brain, which leads to “the obstruction of blood vessels” and results in brain damage. “New research points to platelets -- known for their role in blood clotting -- as playing an important role in the disease, stimulating the immune system and turning on molecules that increase inflammation.”

Scientists at the University of Rochester Medical Center conducted this study as “part of an ongoing effort to better understand the origin and development of cerebral malaria, which predominantly affects children under the age of 10 living in malaria-endemic areas, such as sub-Saharan Africa.”

"Malaria is a complex disease and we need to look at it from every possible angle, focusing on both vaccine research and basic research, as we've done in this study," said Craig Morrell, D.V.M., Ph.D., assistant professor within the Aab Cardiovascular Research Institute at the Medical Center and lead author of the study. "Our findings increase our knowledge of cerebral malaria and suggest that targeting platelets may prove to be a viable intervention strategy."

Malaria is responsible for approximately 1 million deaths each year. 250-500 million people are afflicted with malaria annually, yet malaria is treatable. Efforts to eradicate malaria are being made internationally. “While research efforts are mainly focused on vaccine development, new therapies to treat malaria are needed, as the parasite that causes malaria -- Plasmodium falciparum -- is becoming resistant to current treatments.”

Morrell's team studies “the development and progression of cerebral malaria, with the goal finding new ways to intervene and treat the disease.” Malaria occurs when the specific parasite infects red blood cells. These infected “blood cells activate platelets, which secrete a key protein…whose job it is to protect against foreign intruders -- in this case, the malaria parasite -- by turning on pro-inflammatory cells, known as monocytes. Monocytes contribute to the inflammation in the blood vessels that leads to obstructions in the brain.”

This study has shown scientists that “the role of platelets is more complex than they initially thought. Ongoing research will focus on when to intervene and influence the activity of platelets, as timing has been found to make a marked difference in the outcome. Additionally, scientists at Rochester are collaborating with researchers from Johns Hopkins University to look at drugs that are approved for the treatment of other conditions to see if they might be effective in treating cerebral malaria.”

Sources:
Kalyan Srivastava, David J. Field, Angela Aggrey, Munekazu Yamakuchi, Craig N. Morrell, Pieter H. Reitsma. Platelet Factor 4 Regulation of Monocyte KLF4 in Experimental Cerebral Malaria. PLoS ONE, 2010; 5 (5): e10413 DOI: 10.1371/journal.pone.0010413

University of Rochester Medical Center (2010, June 1). Cerebral malaria: Scientists advance understanding of deadly form of malaria in children. ScienceDaily. Retrieved June 2, 2010, from http://www.sciencedaily.com¬ /releases/2010/06/100601114639.htm

Photo from Davidson College: http://www.davidson.edu/academic/psychology/ramirezsite/neuroscience/psy324/rebergner/malariabrain.jpg

In the midst of global warming

2010-05-27T12:15:00.001-04:00

Doomsday reports of malaria epidemics, stirred by global warming, have reared ominously for decades. New studies show that contrary “to a widespread assumption, global warming is unlikely to expand the range of malaria because of malaria control, development and other factors that are at work to corral the disease.”

“Scientists and public policy makers have been concerned that warming temperatures would create conditions that would either push malaria into new areas or make it worse in existing ones.” But a team of scientists, “including two University of Florida researchers, … analyzed a historical contraction of the geographic range and general reduction in the intensity of malaria -- a contraction that occurred over a century during which the globe warmed. They determined that if the future trends are like past ones, the contraction is likely to continue under the most likely warming scenarios.”

"If we continue to fund malaria control, we can certainly be prepared to counteract the risk that warming could expand the global distribution of malaria," one researcher said.

Malaria “control efforts over the past century have shrunk the prevalence of the disease”. "The globe warmed over the past century, but the range of malaria contracted substantially," Researcher Tatem said. "Warming isn't the only factor that affects malaria."

Reduction in malaria prevalence is attributed to mosquito control efforts, better health care, urbanization, and economic development. “The banned pesticide DDT was instrumental in ridding the disease from 24 countries in Southern Europe, the former Soviet Union and elsewhere in the world between 1955 and 1969.” “Researchers debate how the U.S. defeated malaria, but the reduction of mosquito breeding grounds, improved housing and reduced emphasis on agriculture that comes with development -- and the reduced risk of bites that accompanies urbanization -- probably played a role,” according to Researcher Smith.

"Malaria remains a huge public health problem, and the international community has an unprecedented opportunity to relieve this burden with existing interventions," Simon Hay, author of the Nature paper, said. "Any failure in meeting this challenge will be very difficult to attribute to climate change."

Sources:
Peter W. Gething, David L. Smith, Anand P. Patil, Andrew J. Tatem, Robert W. Snow, Simon I. Hay. Climate change and the global malaria recession. Nature, 2010; 465 (7296): 342 DOI: 10.1038/nature09098

University of Florida (2010, May 19). Malaria control to overcome disease’s spread as climate warms. ScienceDaily. Retrieved May 27, 2010, from http://www.sciencedaily.com /releases/2010/05/100519143413.htm

Threatening malaria

2010-05-19T10:26:00.001-04:00

"Malaria parasites can detect when they are being threatened and change their behaviour to survive, new research has suggested." Changes in behavior may "explain how malaria" resists "drug treatment".

The study, conducted in Edinburgh, provides insight that "could lead to better control of the disease."

"Caused by a parasite called Plasmodium, malaria is spread through the bites of infected mosquitoes and kills around a million people in the world each year. Some of the parasites multiply in the bloodstream and others change into a specialised transmission form, which enables the disease to spread."

The study indicates that "when exposed to low doses of anti-malarial drugs, this delicate balance of replicating and transmitting is upset." Malaria parasites respond to the drugs by attempting to increase "their chances of survival through a safety-in-numbers strategy: they produce fewer transmission forms and concentrate more on replication."

Malaria illness produces symptoms in a cyclical pattern. This pattern corresponds with the reproduction of the parasite. "If drugs push parasites into producing more replicating stages, which cause the symptoms, then this may lead to more serious illness," says Dr. Sarah Reece, from the University of Edinburgh's school of biological sciences. "This study uncovers a new way that parasites are able to resist the effects of drugs. This is also likely to have important implications for human disease control strategies."

Source:

Reece, Sarah. Proceedings of the Royal Society. The Press Association. 19 May 2010. http://www.google.com/hostednews/ukpress/article/ALeqM5h42KsAItyKjo2vyhBDIMEBvAOdNA

Containment cells

2010-05-16T19:16:00.001-04:00

When a human hurts another, the solution is often to restrict the aberrant human to a containment cell. The same principle may be applied to malaria parasites to prevent them from killing their human host.

Seeking to "block invasion of healthy red blood cells by malaria", researchers at the Harvard School of Public Health have "succeeded in locking the parasites within infected blood cells, potentially containing the disease."

"The findings reveal an essential step in the biology of the most common and severe malaria parasite, Plasmodium falciparum, and offer a new drug target for fighting one of the world's most common and dangerous infections."

"Working with the malaria parasite...the research team identified a single fast-acting protein …that enables it … to escape from a human red blood cell in preparation for quick invasion of many more healthy blood cells." If the protein is eliminated, then the escape plan is foiled.

Malaria parasites reproduce in red blood cells, producing up to 32 offspring every two days. Then, the parasites "burst out to infect more red blood cells."

"This is the stage where things have to happen very fast for the parasite," said senior author Manoj Duraisingh, HSPH assistant professor of immunology and infectious diseases and senior author of the paper in the May 14 Science. "The parasite doesn't like to spend much time outside the cell. It grows and matures, and immediately following rupture, enters a new cell. It was a surprise that this protein kinase, which we thought would be involved in red blood cell invasion, turns out to be essential for the parasite getting out of the cell."

"When the parasite gets out of the red blood cell, it has a matter of seconds or minutes to get into new red blood cells, or it will be cleared or killed by the human immune system."

Fortunately, this particular protein "is found in the parasite and in plants, but not in humans, which means a drug targeted to that protein may be less toxic for people."

Read more: Harvard School of Public Health (2010, May 14). New twist on potential malaria drug target acts by trapping parasites in cells. ScienceDaily. Retrieved May 16, 2010, from http://www.sciencedaily.com¬ /releases/2010/05/100514171912.htm

Source:
J. D. Dvorin, D. C. Martyn, S. D. Patel, J. S. Grimley, C. R. Collins, C. S. Hopp, A. T. Bright, S. Westenberger, E. Winzeler, M. J. Blackman, D. A. Baker, T. J. Wandless, M. T. Duraisingh. A Plant-Like Kinase in Plasmodium falciparum Regulates Parasite Egress from Erythrocytes. Science, 2010; 328 (5980): 910 DOI: 10.1126/science.1188191

Childhood deaths

2010-05-12T23:20:00.001-04:00

"Preventable infectious diseases cause two-thirds of child deaths, according to a new study published by The Lancet." Based on information provided by the World Health Organization (WHO) and UNICEF's Child Health Epidemiology Reference Group (CHERG), the study examined causes of childhood death in 193 countries. "While the number of deaths has declined globally over the last decade, the analysis reveals how millions of children under five die every year from preventable causes."

It is estimated that 8.8 million children die annually. Over 5.5 million children die from pneumonia, diarrhea, malaria, and other infectious diseases. These diseases are preventable and treatable, but many victims are unable to reach or afford prophylactics or proper medical care.

"These findings have important implications for national programs," said UNICEF Chief of Health, Dr. Mickey Chopra. "The persistence of diarrhea, pneumonia and malaria, all of which are easily preventable and curable but which nonetheless remain the leading single causes of death worldwide, should spur us to do more to control these diseases."

Read more: Johns Hopkins University Bloomberg School of Public Health (2010, May 12). Infectious diseases caused two-thirds of the nearly 9 million child deaths globally in 2008. ScienceDaily. Retrieved May 12, 2010, from http://www.sciencedaily.com¬ /releases/2010/05/100511201732.htm

Source:
Robert E Black, Simon Cousens, Hope L Johnson, Joy E Lawn, Igor Rudan, Diego G Bassani, Prabhat Jha, Harry Campbell, Christa Fischer Walker, Richard Cibulskis, Thomas Eisele, Li Liu, Colin Mathers, for the Child Health Epidemiology Reference Group of the World Health Organization and UNICEF. Global, regional, and national causes of child mortality in 2008: a systematic analysis. The Lancet, 2010; DOI: 10.1016/S0140-6736(10)60549-1

Safer anti-malarials

2010-05-10T07:05:00.001-04:00

In the arms race against malaria, humans wield the biggest weapons, but their cost is great. In recent years, malaria has mutated and adapted to resist the drugs used to combat it. Caused by a parasite and transmitted by mosquitoes, malaria is an infectious disease that kills nearly one million people each year. Humans struggle to prevent malaria transmission and to treat those infected with the deadly disease.

Unfortunately, some of the malaria treatments are potentially deadly as well. "Amodiaquine was introduced as an antimalarial drug, but. . . withdrawn from the market when it became clear that the drug caused serious adverse effects in the form of liver damage and impaired immune system." The drug is still used in the most severe cases of drug-resistant malaria. It saves lives, but endangers them as well.

Endeavoring to create safer drugs, scientists at the University of Gothenburg, Sweden, studied the byproducts of drugs, looking for toxins. "A pharmaceutical in the body is, in the optimal case, broken down into harmless products (metabolites) that leave the body, for example via the urine. Some pharmaceuticals, however, can be converted into toxic products, which may result in serious adverse effects." Proposed by Tove Johansson Mali'n, the scientists uncovered a process that can "simulate the metabolism of pharmaceuticals in the body". In this way they can identify and characterize several potentially toxic products that arise as the metabolites of drugs". With the aid of this methond, Mali'n "has now managed to identify. . . previously unknown metabolites that may have caused, or contributed to, the adverse effects of amodiaquine."

"We hope that the method can simplify the work of identifying potentially toxic metabolites at an early stage, and thus facilitate the development of safe drugs," says Tove Johansson Mali'n.

Tove Johansson Mali'n, Lars Weidolf, Neal Castagnoli, Ulrik Jurva. P450-catalyzed vs. electrochemical oxidation of haloperidol studied by ultra-performance liquid chromatography/electrospray ionization mass spectrometry. Rapid Communications in Mass Spectrometry, 2010; 24 (9): 1231 DOI: 10.1002/rcm.4505
University of Gothenburg (2010, May 9). New method for developing safer drugs. ScienceDaily. Retrieved May 10, 2010, from http://www.sciencedaily.com¬ /releases/2010/05/100509202645.htm

Quiescence

2010-05-07T07:02:00.000-04:00

How does a vampire avoid that which kills him? He plays dead.

Plasmodium falciparum, a deadly disease known as malaria, proves just as apt to play dead as a fictive vampire facing the sunlight. Humans had a secret weapon against malaria. "Artemisinin (ART), a substance extracted from a Chinese plant," was "the first-line drug for malaria," since other compounds lost their efficacy from overuse and parasite mutation. Artermisinin-based Combination Therapies (ACT) were "the most effective treatment for malaria, achieving a 95% cure rate."

Then, malaria played dead.

In July 2009, artemisinin-resistant malaria was identified in South East Asia. Scientists, desperate to determine how malaria avoided their once brutal weapon, ran laboratory studies.

Françoise Benoit-Vical and his team at Laboratoire de Chimie de Coordination (CNRS) "sought to isolate ART-resistant strains in an experimental manner. This feat was achieved at the end of 2009 when the scientists managed to obtain a strain of Plasmodium falciparum that was resistant to this compound and some of its derivatives, and the first to be adapted to in vitro culture." In the process, the "researchers also identified and characterized a new mode of parasite resistance. To evade the action of ART, Plasmodium falciparum arrested its development and entered a so-called state of quiescence [temporary inactivity]. It thus functioned at a slow metabolic rate until the drug was eliminated", at which time, it would reawaken and wreak havoc again.

"Malaria still continues to kill nearly a million people each year throughout the world. There is no vaccine against this infectious disease", which is caused by a blood parasite and transmitted by mosquitoes."

This study demonstrated "a novel resistance mechanism" and provides "important tool that will allow a clearer understanding of the mechanisms of resistance to antimalarial drugs". Scientists plan further studies in order to "identify the genes responsible for the acquisition of ART resistance."

Sources:
Physorg.com. "How the parasite responsible…" 5 May 2010. http://www.physorg.com/news192300284.html
Witkowski B, Leličvre J, López Barragán MJ, Laurent V, Su XZ, Berry A, Benoit-Vical F. "Increased tolerance to artemisinin in Plasmodium falciparum is mediated by a quiescence mechanism." Antimicrobial Agents and Chemotherapy. Mai 2010.

Pooling resources

2010-05-06T09:57:00.000-04:00

South Africa aims to "speed development of drugs for neglected tropical diseases by freely sharing patented information owned by drug companies and academic institutions." The country "will use a new 'patent pool' to work on new drugs for tuberculosis and malaria, making it the first government to take advantage of the industry-led idea."

After GlaxoSmithKline set up a pool to share patents, in the effort to create an effective malaria vaccine, South Africa saw the possibility to use vast research from various channels to create medications that will change the world.

"The pool contains more than 2,300 patents that are available for use by industry, non-profit groups and academic researchers to develop new medicines for malaria, cholera and more than a dozen other diseases."

"This patent pool is an enormous boost for us to have a significant impact in South Africa," according to Mamphela Ramphele, chairwoman of the South African Technology Innovation Agency. "Her agency will coordinate and nurture drug development among local companies".

The patent pool is a tremendous wealth of information, providing not only "free use of patents, but also know-how and expertise".

"Frankly, expertise and know-how are often some of the more valuable aspects of drug development, and also things that companies don't usually share," says Melinda Moree, chief executive of BIO Ventures for Global Health. "This pool has both of these things (patents and expertise), which I think makes it fairly unusual."

"Moree said other large drug companies are interested in signing up to the pool, but would not name them. The pool contains patents for compounds that have a potential to be developed into drugs."

The pool opens "up the innovation process around drug development for neglected disease." Millions of people suffer every day. "Drug development has lacked. Tens of millions of people are too poor to pay for the drugs". "This is really a step on the part of industry to try a new model around one of the things that has sparked contentious debate around intellectual property," Moree said.'

In the past, some pharmaceutical companies received criticism for "fiercely backing patents that blocked cheaper competitors, even in the poorest countries, where brand-name medicines were unaffordable." GlaxoSmithKline and some other companies responded by "selling AIDS drugs in certain areas without a profit and offering licenses to generic makers." Companies and countries are now joining together with the common goal of disease eradication at all costs.

Source:
Steenhuysen, Julie. "S. Africa taps patent pool for neglected diseases." Reuters. 5 May 2010.

Malaria in Ethiopia

2010-05-04T22:57:00.002-04:00

In 2005, US President George W. Bush instituted the President's Malaria Initiative (PMI) to "fight malaria in the region most affected by the disease. The President committed. . . $1.2 billion in malaria funding to this Initiative with the goal of reducing malaria-related deaths by 50 percent in 15 focus countries", including Ethiopia.

Five years later the PMI is still going strong. On the 26th of April 2010, "[t]housands of Long-Lasting Insecticidal Nets, or mosquito bed-nettings, were handed out by a U.S. Army Civil Affairs team to the people" in malaria-endemic regions of Ethiopia.

"We are distributing 35,000 nets to a population of approximately 93,000 people," said Lieutenant Daniel Deckard, commander of the Civil Affairs team, Combined Joint Task Force-Horn of Africa. "That's approximately two nets per household," he said.

The distributed nets are treated with insecticides to repel and kill mosquitoes in addition to serving as a physical barrier between humans and flying insects. Insecticide treated nets are estimated to be twice as effective as standard nets and may reduce malaria transmission by up to seventy percent (when used correctly). Participants in the PMI not only distribute nets, they are also "properly installing the nets in optimal locations within homes and are giving directions and other vital information to homeowners about proper use to minimize possible hazards and maximize protection" against malaria.

Malaria "is one of the leading causes of the deaths of pregnant women and children under five years of age in Africa. . .Malaria is a blood-borne infection caused by parasites and transmitted to people by the bite of female Anopheles mosquitoes, which are active from dusk to dawn, according to the PMI website. Malaria usually begins as a flu-like illness with fever and chills. Mild to moderate anemia is also common because the malaria parasite infects and destroys red blood cells."

Untreated, malaria may cause severe anemia, organ failure, coma, and death.

Based on the annual reports (reporting began in 2006), malaria relief efforts are producing results. For example:
* Zambia has seen a 10% decrease in malaria cases
* In Rwanda, child mortality rate has dropped from 168 deaths/1,000 to 119 deaths/1,000
* Infant mortality rate in Tanzania has also dropped

The initiative expects to see similar or better improvements in Ethiopia.

Sources:
Barnett, Robert. "Fighting Malaria in Ethiopia". The Ethiopian Review. 4 May 2010. http://www.ethiopianreview.com/articles/32007

PMI: Saving Lives in Africa. http://www.fightingmalaria.gov/

Hope for Haiti

2010-05-04T00:09:00.006-04:00

Spraying DDT in 1958 as part of The United States' National Malaria Eradication Program

The source article for this post should be considered an editorial, and it expresses the opinions of Henry I Miller.

Is there a hope for Haiti?

"On top of the almost unimaginable devastation caused by January's earthquake in Haiti, the nation is bracing for the ravages of the rainy season." Torrential downpours already flood homes and turn "tent cities into muddy misery. Ominously, the number of cases of malaria, which is spread by the bite of mosquitoes and which was endemic in Haiti even before the earthquake, is increasing."

Aid groups plan to distribute over three million bed nets in order to minimize the number of malaria cases. However, this "ultra-low-tech" solution stands as "only modestly effective intervention". "What is really needed is the chemical DDT, an old, cheap and safe tool to control the vector -- the Anopheles mosquito -- that spreads the disease."

"Malaria is a scourge of humanity, particularly for the inhabitants of poor tropical countries." Over forty percent of the world's population lives at-risk for contracting malaria. 350 to 500 million cases of malaria occur worldwide each year. It is "a crushing economic burden on malaria-endemic countries" and impedes economic growth.

Once contracted, malaria is treatable. "A drug called chloroquine is a useful preventive but many strains of the malaria parasite in Haiti have developed resistance to it." Artemisinin-combination medicines "are safe and exhibit potent, rapid antimalarial activity", but resistance to these drugs is also rising. It is clear "that in the absence of a vaccine", "elimination of the mosquitoes that spread the disease is the key to preventing epidemics."

"Unfortunately, flawed public policy limits the available options."

Humans, armed with the weapon of DDT, are capable of destroying the deadly mosquito population; however, "on the basis of data on toxicity to fish and migrating birds" the U.S. Environmental Protection Agency (EPA) banned "virtually all uses of the pesticide DDT" in 1972. Subsequently, DDT was banned for "agricultural use worldwide under the 2001 Stockholm Convention on Persistent Organic Pollutants, which stigmatized the chemical and effectively constituted a prohibition."

"Although DDT is a (modestly) toxic substance, there is a vast difference between applying large amounts of it in the environment -- as farmers did before it was banned -- and using it carefully and sparingly to fight mosquitoes and other disease-carrying insects."

DDT is an effective pesticide because it is long lasting, and it works by poisoning and repelling mosquitoes. Treatment of mosquito breeding grounds prevents malaria transmission by reducing the insect population. Spraying DDT in homes and on door frames repels adult mosquitoes and prevents malaria transmission within the home. Because of its dual effectiveness, it is logical to assume that DDT will help prevent malaria even if mosquitoes develop resistance to it…a resistance that is yet to manifest.

"Since the banning of DDT, insect-borne diseases such as malaria and dengue have been on the rise. In fact, the huge toll of diseases spread by mosquitoes caused some public health officials to rethink DDT's use…In 2006, after some 50 million preventable deaths, the U.N.'s World Health Organization reversed course and endorsed the use of DDT to kill and repel malaria-causing mosquitoes."

"Poor tropical countries like Haiti where malaria is endemic desperately need cheap, effective control of mosquitoes. Instead of continuing the politically correct stigmatization of DDT, United Nations agencies and NGOs such as the Red Cross should be rushing supplies of it to Haiti."

Henry I. Miller, a physician and molecular biologist, is a fellow at Stanford University's Hoover Institution. He was an official at the NIH and FDA.

Read more: http://www.miamiherald.com/2010/05/03/v-fullstory/1610610/ddt-can-stymie-malaria-carrying.html#ixzz0mvfg9aS4

Source:
Miller, Henry I. "DDT can stymie malaria-carrying mosquitoes in Haiti." Miami Herald. 3 May 2010.

Never too young or too small

2010-05-02T19:50:00.001-04:00

Determined to help prevent needless deaths from malaria, middle school students in Westfield, Massachusetts set a lofty fundraising goal of $5,000. They raised money to purchase mosquito nets through the Nothing but Nets program, which sends mosquito nets to families in Africa. After learning that experts estimate that "one child dies every 30 seconds from malaria", this group of 93 students diligently campaigned to save lives.

Their fund-raising project succeeded in meeting and surpassing their goal. The seventh-grade students "raised more than $18,000 for the cause". For their efforts, the director of Nothing but Nets, Adrianna Logalbo, "presented the students with the first ever Notable Net Raisers Award". Mozzie the Mosquito, the project mascot, joined Logalbo in praising the fund-raising effort.

"Logalbo said that with the assistance of North Middle School the project has sent more than 3 million mosquito nets to families in Africa. She said the project was started four years ago and has raised over $30 million."

Donate to Nothing But Nets

Source:
LaBorde, Ted. "Westfield students raise money to fight malaria…" The Republican. 2 May 2010. http://www.masslive.com/news/index.ssf/2010/05/westfield_students_raise_money.html

Banishing malaria

2010-04-30T22:45:00.001-04:00

"On Hispaniola, home to the nations of Haiti and the Dominican Republic, malaria is caused by a single mosquito-borne parasite, Plasmodium falciparum" (Joseph). Hispaniola remains as "the last island in the Caribbean where the disease occurs regularly." Researchers from Tulane University claim that "success in eliminating malaria from Hispaniola would demonstrate that it is possible to defeat malaria in other regions of the world where it remains a dire threat. There is also evidence in Haiti that the parasite is becoming resistant to chloroquine, an inexpensive treatment for the disease. Eliminating malaria now would save these impoverished nations from having to resort to more expensive drug therapies."

In order to banish malaria from Hispanola, the countries must adopt more intensive mosquito-control methods. Every suspected malaria case should be diagnosed properly and treated.

"Success will require the 'unwavering political will' of both governments on the island, and will 'set a precedent for health diplomacy'"(Tulane).

Sources:

Joseph Keating, Donald J Krogstad, Thomas P Eisele. Malaria elimination on Hispaniola. The Lancet Infectious Diseases, 2010; 10 (5): 291-293 DOI: 10.1016/S1473-3099(10)70075-X

Tulane University (2010, April 28). Researchers call for eliminating malaria in Haiti and the Dominican Republic. ScienceDaily. Retrieved April 30, 2010, from http://www.sciencedaily.com /releases/2010/04/100428121457.htm

New species of human malaria

2010-04-27T10:21:00.001-04:00

Over two-hundred species of malaria exist, but few infect humans. "Plasmodium falciparum and Plasmodium vivax are the most common. Plasmodium falciparum is the most deadly" (WHO). While investigating the fourth type of human malaria, Plasmodium ovale, scientists "confirmed that the parasite is actually two similar but distinct species which do not reproduce with each other" (London).

"Researchers from the London School of Hygiene & Tropical Medicine, the Hospital for Tropical Diseases and Mahidol University, Bangkok collaborated last year in order to share their research after noticing that the single parasite Plasmodium ovale, though visible through a microscope, was not detected by forensic DNA tests designed to identify the species."

According to lead researcher, Dr. Colin Sutherland, it "was a great surprise to find that, not only are these two species completely distinct from each other by every test we carried out, they actually occur in people living side by side" in the same towns. "We hope to continue our work so we can unravel the mysterious differences between these two newly recognized human pathogens," he says (Sutherland).

Sources:
London School of Hygiene & Tropical Medicine (2010, April 19). New species of human malaria recognized. ScienceDaily. Retrieved April 27, 2010, from http://www.sciencedaily.com¬ /releases/2010/04/100419150951.htm

Sutherland et al. Two Nonrecombining Sympatric Forms of the Human Malaria Parasite Plasmodium ovale Occur Globally. The Journal of Infectious Diseases, 2010; 201 (10): 1544 DOI: 10.1086/652240

WHO. "Malaria fact sheet." http://www.who.int/mediacentre/factsheets/fs094/en/

World Malaria Day

2010-04-20T08:21:00.008-04:00

25 April 2010 is World Malaria Day

A parasite poisons hundreds of millions of people. The ancient illness kills nearly a million humans each year. Yet, this infectious disease is treatable and preventable.

Fragile mosquitoes flit through the tropical breezes. Poised on delicate feet, the insect prepares to feed. With a thwack, a slap of a hand, the mosquito melts into a smear of blood. Malaria has been defeated, at least in that instant.

Transmitted by mosquitoes, the malaria parasite may be deadly to humans, but many vectors for control exist. Prevention measures like pesticide spraying, reservoir draining, and insect-repellent bed-net distribution prevent the breeding and biting of mosquitoes. Fewer mosquitoes mean fewer vehicles in which malaria may travel.

Doctors around the globe strive for a vaccine that will prevent malaria infection, but a perfected vaccine has yet to be developed. Still, medicine plays a pivotal part in preventing malaria deaths. Traditional medicines like Artemisinin, Quinine, and Chloroquine are still used to treat the disease, but drug-resistant malaria has evolved in many parts of the world. New combination therapies are implemented to fight the illness, but the situation resembles an arms race. Medics and malaria struggle to keep the upper-hand, and we see an escalation in the strength of weapons needed to fight the deadly disease.

"Malaria defeated the international community many years ago. We cannot allow this to happen again," said Margaret Chan, director-general of the World Health Organization. Many so-called developed countries have expelled malaria from their territories, yet the disease is still endemic in much of the world. Malaria is a global problem, and it affects the global community. The mosquitoes that transmit the disease do not heed political boundaries or economic status. If one country suffers from rampant malaria, then the world risks the global spread of disease.

Eradicating malaria is not a simple task, but it can be done. The parasite changes, mutates, and evolves to ensure its survival, but humans can outwit this evolution. Concentrated effort to prevent and treat malaria drastically reduces the number of ill and diminishes the number of deaths in a region. And, it isn't just trained medical professionals who can help fight malaria on a global scale. One of the biggest efforts to combat malaria comes from mosquito-net distribution.

Bed-nets prevent malaria-infested mosquitoes from biting people while they sleep. Insecticide treated nets are the most effective, but even a standard net is better than no protection. Donations to support the distribution of mosquito nets are collected on a global scale. Please visit Malaria No More or Nothing But Nets to contribute to a net-distribution program.

Other ways you can help:
* Donate
Malaria is an economic drain on the countries and communities where the disease is endemic. Donations are needed to provide medical treatment and to support preventative measures in places where malaria is most prevalent. Please only donate to reputable organizations. Infectious Bite suggests Malaria No More, the CDC Foundation, and Nothing But Nets.

* Help
Volunteer in anyway that you can. Medical personnel are always needed in endemic regions, but non-medical volunteers are also needed. Volunteers distribute mosquito nets, disrupt and destroy mosquito breeding grounds, and educate at-risk individuals about proper use of insecticides and other preventative measures.

* Start
Start an awareness project of your own. Compared to activism for many other causes, anti-malaria offensives are still developing to find novel ways to fight the disease. Media publications reveal the signs of "an evolving 'malaria activism' (akin to AIDS activism)" (Public). "Probably no other disease in human history has been associated with social and political activism to the extent that the HIV epidemic has" (AIDS Activism). "Such activism played a huge role in reducing the costs of anti-retroviral drugs in developing countries" (PLoS). Outspoken individuals are needed to raise awareness in their communities. Small actions are indispensable to the global effort of malaria awareness.

World Malaria Day "is a day for recognizing the global effort to provide effective control of malaria." Instituted by the World Health Assembly in May 2007, World Malaria Day seeks to engage everyone at moving toward the goal of eliminating the global problem of malaria (WHO).

"Approximately half of the world's population is at risk of malaria, particularly those living in lower-income countries. It infects more than 500 million people per year and kills [approximately] 1 million. The burden of malaria is heaviest in sub-Saharan Africa but the disease also afflicts Asia, Latin America, the Middle East and even parts of Europe" (WHO).

World Malaria Day is an opportunity:
*for countries in the affected regions to learn from each the experiences of others and support each global efforts;
*for new donors to join a global partnership against malaria;
*for research and academic institutions to flag their scientific advances to both experts and general public; and
*for international partners, companies and foundations to showcase their efforts and reflect on how to scale up what has worked

Join us, and join the world as we fight to bring an end to malaria illness and deaths. Together we can bite malaria back.

Links to visit:
World Malaria Day: http://www.worldmalariaday.org
Roll Back Malaria: http://www.rollbackmalaria.org/worldmalariaday/
WHO: http://www.who.int/mediacentre/events/annual/malaria/en/index.html

Sources:
AIDS Activism. http://www.albany.edu/sph/AIDS/activists.html

PLoS. "Time for a Third Wave of Malaria Activism." http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000188

Public Library of Science. "It's Time for a 'Third Wave' of Malaria Activism to Tackle Drug Shortages." ScienceDaily 23 November 2009. 24 November 2009 .

Roll Back Malaria. "Key Facts, Figures, & Strategies." http://www.rollbackmalaria.org/gmap/GMAP_Advocacy-ENG-web.pdf

Yarney, G. "Roll Back Malaria." http://www.plosmedicine.org/article/findArticle.action?author=Yamey&title=Roll%20Back%20Malaria:%20A%20failing%20global%20health%20campaign.

Malaria in Angola

2010-04-18T10:43:00.003-04:00

Located on the West African coast, Luanda is Angola's chief seaport and capital. For years, Angola has waged war against malaria by providing medical treatment, distributing medicine and mosquito nets, and reconstructing the capital city. Social housing built to replace slums has reduced the urban risk of contracting malaria. Better health facilities prevent the ill from dying, and mosquito nets reduce the likelihood of mosquito bites, which may transmit malaria.

"Angola's health systems were severely damaged during the civil war," [ending in 2002] after which "only about 30 percent of the population had access to government health facilities. Malaria accounts for an estimated 35 percent of mortality in children less than five years old, 25 percent of maternal mortality, and 60 percent of hospital admissions for children under age five" (USAID).

Luanda reports that "the number of malaria cases dropped from four million to three million in recent years". "Speaking on the celebrations of the malaria world day [on 25 April], Filomeno Fortes [Ministry of Health] stated that the number of deaths also decreased from 20,000 to 9,000 as a result of the anti-malaria campaigns, namely through sensitization actions, distribution of mosquito nets, the anti-larvae combat and the initiative of the US president."

"Angola is one of three first-round target countries benefiting from the U.S. President's Malaria Initiative (PMI), a five-year $1.2 billion initiative led by the U.S. Agency for International Development (USAID). . . PMI's long-term goal is to cut malaria deaths by 50 percent in 15 African countries by providing lifesaving services, supplies, and medicines to 85 percent of those most vulnerable to malaria -- children under five years of age and pregnant women" (USAID).

Fortes hopes to equip every health unit in the country with COARTEM, anti-malaria tablets, by the end of the year.

"Dr Fortes revealed that the government will launch on April 25 an anti-larvae program with the aim to boost the campaign against the disease" (AngolaPress)

Source:
AngolaPress. "Malaria cases dropped. . ." 18 April 2010.
USAID. Country Profile: Angola. May 2008. http://www.usaid.gov/press/factsheets/2006/CP_Angola_6-06.pdf

Stayin' Alive

2010-04-15T09:09:00.003-04:00

Malaria No More (MNM) chooses Jason Castro, American Idol season seven finalist, as the "Stayin' Alive" Ambassador. "The Stayin’ Alive campaign is the new grassroots movement that MNM has started to get American students involved in fighting malaria through dances and similar events to raise awareness about the disease."
Castro became involved with Malaria No More during Idol Gives Back, American Idol's Charity program. He "learned about the thousands of children that die daily from this dreaded disease."

Castro is excited to join Malaria No More's efforts to educate students and encourage their involvement. He says, "I was personally surprised to learn that malaria continues to be an epidemic in parts of the world, so I’m thrilled to do whatever I can to raise awareness of the continuing fight against this disease."

"It is estimated to be up to a half a billion cases of malaria annually with about 1 million deaths, particularly among young children. People contract malaria through the bite of an infected female Anopheles mosquito."

For more information on the "Stayin' Alive" campaign, visit Malaria No More

Source:
Examiner.com 15 April 2010. http://www.examiner.com/x-7707-Infectious-Disease-Examiner~y2010m4d14-Former-American-Idol-Jason-Castro-joins-fight-against-malaria

A brush with death

2010-04-14T09:43:00.001-04:00

"U.S. Marine Corps veteran Frederick 'Fritz' Payne" witnessed a great deal of death while flying his fighter plane "over the Pacific during World War II". "Although his plane took a beating during combat missions -- returning to base with numerous bullet holes — Payne said he only had one really close brush with death."

"It was when I got malaria," he said.

At high altitudes, pilots must wear oxygen masks; without the constant flow of oxygen they risk death. "When you get malaria, you naturally get sick," he said.

"When I got sick I vomited in my oxygen mask, and it cut off my oxygen."

"The next thing I knew, I was going around in circles," he said.

As the plane spiraled out of control, Payne lost consciousness.

"When I came to, I was at about 8,000 feet and the plane was going down," he said. Still groggy from the black-out, Payne managed to pull his plane from its downward plummet. The fighter pilot survived, but he remembers malaria as a deadly enemy.

Source:
Goolsby, Denise. "Ace fought enemy, malaria over the Pacific." The Desert Sun. 14 April 2010.

World Health Day

2010-04-07T09:35:00.006-04:00

This year the WHO's (World Health Organization) World Health Day focuses on urban health, campaigning in 1000 cities and collecting personal stories from 1000 individuals involved in urban health. Infectious Bite encourages you to read more about World Health Day 2010 and urban health and to get involved in your city's campaign for Global Health.

In 1960, the focus of the World Health Day initiative was "Malaria eradication -- a world challenge". For Infectious Bite, World Health Day 2010 marks the fifty-year anniversary of the malaria eradication challenge posed by the World Health Organization.

This Was Then:
According to The Hindu's (India's National Newspaper) publication from 7 April 1960, in "over ninety countries anti-malarial operations are in progress. In many countries a remarkable decrease in the incidence of this enervating disease, which in past ages has caused the collapse of kingdoms, has been registered. But the World Health Organisation has recorded the fact that 'there are still fifty-six countries where no effort has yet been made to subdue in malaria monster'. In India much progress has been made and large areas freed of this menace. . . .(Mosquitoes, however, still continue to flourish: Madras, for instance, had an unusually large number of them last cool season and they still seem to be with us)."

This Is Now:
Global efforts toward malaria eradication are underway, but each year lives are still lost. Estimates report that 800,000-1 million deaths occur each year due to malaria. According to the 2009 World Malaria Report, "tremendous increase in funding for malaria control is resulting in the rapid scale up of today's control tools. This, in turn, is having a profound effect on health -- especially the health of children in sub-Saharan Africa. In a nutshell, development aid for health is working" (7). The report also calls for continued action. "We can save millions of lives over the coming years by scaling up the malaria control tools that we already have available. However, we know that the malaria parasite is a formidable opponent, and that if we are to ultimately eradicate malaria, we need new tools. The unprecedented recent spending on the research and development of these tools, including a vaccine against malaria, is a critical component of the long-term strategy against malaria" (7).

Showing Progress [Quoted from the 2009 World Malaria Report]

*International funding commitments for malaria control have increased from around US$0.3billion in 2003 to US$1.7 billion in 2009 due largely to the emergence of the Global Fund and greater commitments of the US President's Malaria Initiative, the World Bank and other agencies

*An increased percentage of African households (31%) are estimated to own at least one insecticide-treated net

*Use of artemisinin-based combination therapies (ACTs) has increased. . . but remains very low in most African countries . . . well-below the WHA target of 80%

* More than one-third of the 108 malarious countries (9 African countries and 29 outside of Africa) documented reductions in malaria cases of > 50% in 2008 compared to 2000

*Ten countries are implementing nationwide elimination programmes of which six entered the elimination phase in 2009

Donations to the Global Fund sponsor malaria relief efforts. Since its creation, the Global Fund estimates that 5 million lives have been saved from Malaria, TB, and AIDS. Read more about the Global Fund.

Malaria is an ancient disease. It will not disappear easily, but in recent years, the world is making progress toward complete malaria eradication. With your help, your donations, and your awareness initiatives malaria may be eradicated in your lifetime. On this World Health Day, bite malaria back.

Sources:
2009 World Malaria Report. http://whqlibdoc.who.int/publications/2009/9789241563901_eng.pdf
The Hindu. "World Health Day (7 April 1960)".
http://www.thehindu.com/2010/04/07/stories/2010040754551401.htm

Drugmakers work together

2010-04-06T08:58:00.001-04:00

Two drugmakers, Crucell NV and GlaxoSmithKline PLC, "will work together on a new malaria vaccine composed of two drugs", which they previously were developing separately.

According to Crucell, "malaria kills about 900,000 people a year, making it one of the deadliest diseases in the world."

The companies worked together "to research a Crucell vaccine in preclinical studies, and want to begin testing their combined vaccine on humans. They said the preclinical research shows the drugs may work better together than they do separately."

"The experimental vaccine combines a GlaxoSmithKline vaccine", called RTS,S/AS, with a developing vaccine by Crucell, which "involves placing a section of genetic material from a virus or parasite into larger 'vehicle' particle similar to the virus that causes the common cold. Crucell says that creates immunity to the disease, and works better against severe infectious diseases than older methods of vaccine creation".

Source:
Associated Press. "Crucell and Glaxo will combine malaria vaccines." Via Forbes. http://www.forbes.com/feeds/ap/2010/04/06/business-health-care-us-crucell-glaxosmithkline_7490454.html

Funding

2010-03-26T07:04:00.002-04:00

To battle three killer diseases--AIDS, Tuberculosis, and Malaria--the United Nations created the Global Fund in 2002 and now hopes to expand it into a Global Health Fund.

Since its creation, the Global Fund has seen spectacular accomplishments, making the fund "arguably the most successful innovation in foreign assistance of the past decade. As a result of Global Fund programmes, an estimated 2.5 million people are on antiretroviral Aids therapy. No fewer than 8 million people have been cured of TB. And more than 100 million long-lasting insecticide-treated bed nets have been distributed in the fight against malaria. In total, studies suggest that Global Fund programmes have saved 5 million lives."

Operational procedures allow the Global Fund to be successful. "Disease-specific committees, called the Country Co-ordination Mechanism (CCM), are constituted in each developing country. Each CCM is chaired by the national government, but incorporates input from non-government organisations to formulate national-scale, disease-specific plans for submission to the Global Fund. Once the Global Fund receives these plans, they are sent to a Technical Review Panel (TRP) to check that the plans are scientifically sound and feasible. If the TRP approves, the plan is sent to the board of the Global Fund, which then votes to approve financing."

Challenges facing the Global Fund include lack of continuous financing and the potential to broaden the Global Fund's mandate. Since 2002, the Global Fund has approved around $19bn in total funding. . .Unfortunately, the Global Fund is already in a state of fiscal crisis. It needs around $6bn per year in the next three years to cover expansion of programmes for the three diseases, but it has only around $3bn per year from donor countries. Unless this is corrected, millions of people will die unnecessarily."

Financial crisis hinders the Global Fund from reaching its new goal, which is to improve basic health and reduce "child and maternal mortality. Expanding the Global Fund's mandate to include financing for training and deployment of community health workers, construction and operation of local health facilities, and other components of primary health systems could ensure the development of these local systems."

"Many countries – including France, Japan, Norway, the United Kingdom, and the United States – have recently recognised the need to move beyond the financing of control of Aids, TB, and malaria to financing improvements in primary health systems more generally. But they seem to view the issue of health-system financing as an either/or choice: scale up control of Aids, TB, and malaria, or scale up financing of primary health systems. The truth, of course, is that both are needed, and both are affordable".

Read More: "Funding a Global Health Fund."

Source:
Sachs, Jeffrey. "Funding a Global Health Fund." Guardian.co.uk. http://www.guardian.co.uk/commentisfree/2010/mar/25/global-health-fund-funding-tb-aids

War of the parasites

2010-03-25T09:14:00.000-04:00

Malaria, a disease that reportedly causes "more than 1 million deaths annually", is caused by a mosquito-borne parasite. But, another blood parasite--this one carried by ticks--may provide malaria resistance.

Like malaria, Babesia parasites "infect a wide variety of mammalian hosts". Of the human "population infected with Babesia microti, 25% of adults and 50% of children remain asymptomatic" (without noticeable symptoms). "A new study suggests that monkeys chronically infected with babesiosis, a tick-borne parasite, are able to suppress malaria infection when exposed to a simian malaria parasite." Other coinfection studies in rodents indicate cross-protection. Researchers conclude that "ongoing infection with B. microti parasites leads to suppression of malaria infection" and may provide a way to combat malaria.

Source:
American Society for Microbiology (2010, March 24). Infection with tickborne parasite may suppress malaria. Retrieved March 25, 2010.

Flying vaccinators

2010-03-21T08:38:00.001-04:00

Everyone hates mosquitoes, right? But, what if a mosquito bite vaccinated you against malaria, a deadly disease that infects approximately 250 million people each year? "New research published in Insect Molecular Biology reveals that mosquito genetic engineering may turn the transmitter into a natural 'flying vaccinator', providing a new strategy for biological control over the disease."

The study, led by Shigeto Yoshida from Jichi Medical University, "targets the saliva gland of the Anopheles stephensi mosquitoes, the main vectors of human malaria."

"For the past decade it has been theorized that genetic engineering of the mosquito could create a 'flying vaccinator,' raising hopes for their use as a new strategy for malaria control. However so far research has been limited to a study of the insect's gut and the 'flying vaccinator' theory was not developed."

Mosquito bites offer a free and easy way to administer a vaccine. Continued "exposure to bites" is expected to produce "high levels of protective immunity, through natural boosting, for a life time. So the insect shifts from being a pest to being beneficial," according to Yoshida.

"While 'flying vaccinator' theory may now be scientifically possible the question of ethics hangs over the application of the research. A natural and uncontrolled method of delivering vaccines, without dealing with dosage and consent, alongside public acceptance to the release of 'vaccinating' mosquitoes, provide barriers to this method of disease control."

Is this idea too dangerous to be beneficial, or is it just radical enough to help eliminate malaria? The world has yet to decide.

Source:
Wiley-Blackwell (2010, March 19). 'Flying vaccinator': Can genetically engineered mosquitoes provide a new strategy against malaria?. ScienceDaily. Retrieved March 21, 2010, from http://www.sciencedaily.com /releases/2010/03/100318192658.htm

Significant progress

2010-03-18T22:04:00.000-04:00

Drug "resistance is most alarming" in parts of "Africa where HIV rates are high and people are extremely vulnerable to infections" (Boseley). But, one of the infectious diseases that terrorizes this region is on the retreat, according to recent findings. "A new report from the Roll Back Malaria (RBM) Partnership confirms that current investment in malaria control is saving lives and providing far-reaching benefits for countries. But it warns that without sustained and predictable funding, the significant" progress could be reversed (Roll Back Malaria).

"Most of us by now have got the message that malaria control is working. The report says that an estimated 384,000 children's lives were saved in 12 countries, such as Ethiopia, Rwanda and Zambia, between 2000 and 2009 through distribution of mosquito nets and other preventive measures. A steady and impressive increase in funding for malaria prevention has brought this about, from $100 million to $1.5 billion over that time period" (Boseley).

Richard Cibulskis of the WHO's global malaria program, warns that "If we are not vigilant about the level of funding going to malaria, the progress we have seen will be quickly reversed". According to the Global Malaria Action Plan [plan to eradicate malaria], "$6 billion a year is needed to ensure universal coverage of malaria control measures".

The money collected for malaria relief "goes mostly to the smaller countries…where the impact is measurably greater" than it would be in a larger country. Recent efforts have reduced the number of malaria deaths, but diligent effort to prevent malaria infection and eradicate the disease is still needed by the global community.

Boseley, Sarah. "Drug resistant tuberculosis…" The Guardian. http://www.guardian.co.uk/society/sarah-boseley-global-health/2010/mar/18/tuberculosis-malaria-prevention. 18 March 2010.
Roll Back Malaria. "Roll back malaria report…" http://www.rollbackmalaria.org/globaladvocacy/pr2010-03-18.html

Duffy negative

2010-03-16T10:37:00.003-04:00

"In a paradigm changing discovery," malaria illness "has been identified in a population historically thought to be resistant to the disease." The Duffy blood group protein, located on the surface of red blood cells, acts as a receptor for the malaria parasite and facilitates malaria illness in humans. Duffy-negative population groups (people who do not have the Duffy antigen) were considered resistant to malaria because their blood cells lacked the receptor through which malaria invades.

However, "according to researchers from Case Western Reserve University School of Medicine, Pasteur Institute, and the Madagascar Ministry of Health", Duffy-negative individuals may experience illness from malaria. "In a study of more than 600 individuals from eight communities covering the main malaria transmission areas of Madagascar, the researchers found that 10 percent of people experiencing clinical malaria were Duffy-negative and infected with P. vivax."

"Since the early 1920s, it has been widely accepted that people of African ancestry are resistant to P. vivax blood-stage infection and clinical malaria. The Duffy-negative blood group, one of the more than 30 blood types, is predominant in most African ethnic groups" (Case). "Duffy-negative people usually have relatively recent ancestors from historically malaria prone regions. The highest concentration of Duffy-negative people in the world is in West Africa, where more than 95% of people are missing the protein on their red blood cells. Reflecting their African ancestry, 68% of African-Americans are also Duffy-negative" (23andme).

Malaria parasites are changing. Mutations allow the parasite population to become resistant to commonly-used drugs, develop in areas of high altitude, and now may enable them to cause illness in Duffy-negative people.

People with "this blood type, can have P. vivax living dormant in their liver cells where it does not make people sick." What "distinguished Duffy-negatives from all others was that the malaria parasite was unable to cross the threshold from liver cells to blood cells." However, during this study the team documented "photographic evidence of the parasite's presence within red blood cells of many Duffy-negative people experiencing malarial illness."

"The study confirms that P. vivax is not dependent on the Duffy antigen for establishing blood-stage infection and disease in Madagascar. Evolution of new parasite strains, infiltrating a new group of people who are Duffy-negative, seems to be occurring within a population of people from different ethnic backgrounds," says Peter A. Zimmerman, Ph.D., the study's senior author and Professor of International Health, Genetics and Biology in the Center for Global Health and Diseases at Case Western Reserve University School of Medicine. "These findings will have a major impact on efforts to eliminate malaria worldwide, particularly in large regions of Duffy-negative west, central and southern Africa."

"In Madagascar, malaria is endemic to more than three-quarters of the island. With almost one million clinical cases reported each year, this disease is a major public health problem" (Case).

Sources:
23andMe. "Malaria resistance." https://www.23andme.com/health/Malaria-Resistance-Duffy-Antigen/howitworks/ [Image]

Case Western Reserve University. "Duffy-Negative Blood Types No Longer Protected from P. Vivax Malaria." ScienceDaily 15 March 2010. 16 March 2010 .

Horuk et al. (1993) . “A receptor for the malarial parasite Plasmodium vivax: the erythrocyte chemokine receptor.” Science 261(5125):1182-4.

Kasehagen et al. (2007) . “Reduced Plasmodium vivax erythrocyte infection in PNG Duffy-negative heterozygotes.” PLoS ONE 2(3):e336.

Michon et al. (2001) . “Duffy-null promoter heterozygosity reduces DARC expression and abrogates adhesion of the P. vivax ligand required for blood-stage infection.” FEBS Lett 495(1-2):111-4.

Protective barrier

2010-03-14T10:07:00.002-04:00

Malaria is a parasite that affects many organisms, yet mosquitoes can carry the disease without it triggering an immune response. How?

"Scientists. . . have found that when the mosquito takes a blood meal, that act triggers two enzymes to form a network of crisscrossing proteins around the ingested blood. The formation of this protein barrier, the researchers found, is part of the normal digestive process that allows so-called "healthy" or commensal gut bacteria to grow without activating mosquito immune responses."

"But there is a downside: The barrier also prevents the mosquito's immune defense system from clearing any disease-causing agents that may have slipped into the blood meal, such as the Plasmodium malaria parasite, which in turn can be passed on to humans." However, scientists believe that disrupting "the protein barrier. . . can trigger mosquito immune defenses to intervene and protect the insect from infection." It is possible that the mosquito's immune defenses will combat and eliminate malaria parasites before they are passed on to humans. Researchers are investigating a vaccine that "would generate antibodies" in humans which, "after a mosquito feeds on" the vaccinated human, "could disrupt the barrier, reduce parasite survival in the mosquito and prevent malaria transmission."

Source:

NIH/National Institute of Allergy and Infectious Diseases (2010, March 14). Barrier in mosquito midgut protects invading pathogens. ScienceDaily. Retrieved March 14, 2010, from http://www.sciencedaily.com¬ /releases/2010/03/100311175043.htm

Improving malaria treatment

2010-03-09T21:17:00.000-05:00

"WHO (World Health Organization) is releasing the first ever guidance on procuring safe and efficient anti-malarial medicines. The guidelines will help countries select and obtain effective, good quality medicines and save lives by improving the way patients are diagnosed and treated" (WHO).

New guidelines recommend "the use of diagnostic tests and a new artemisinin-based combination therapy". Robert Newman, "director of the WHO global malaria" program, said "It is time to move away from the idea that everyone with a fever is suspected to have malaria" (Bernama).

Tests to determine whether or not malaria is the febrile culprit are necessary to prevent further drug-resistant malaria from developing. However, reliable tests are expensive and unavailable in rural villages, where they are most needed. "The WHO. . . recommended the rural health clinics, where microscopes are often unavailable, use Rapid Diagnostic Tests because they are easy for community health workers to handle" (Bernama).

"Each year there are 250 million cases of malaria and 860,000 deaths as a result. Approximately 85 percent of the deaths are children" (Bernama).

Malaria treatment guidelines: http://www.who.int/malaria/publications/atoz/9789241547925/en/index.html

Bernama. "WHO releases new malaria treatment guidelines." 10 March 2010. http://www.bernama.com/bernama/v5/newsworld.php?id=481148

WHO. "Improving malaria diagnosis and treatment." 09 March 2010. http://www.who.int/en/

Drug-resistant malaria

2010-03-07T16:04:00.001-05:00

"In a dusty village near the Thai-Cambodia border, 24-year-old Oeur Samoeun sits on a dark green hammock recovering from a strain of malaria that has resisted the most powerful drugs available. . . Ravaged by days of fever and chills, he is considered lucky: the parasite has left his body. But for many others, the potentially deadly disease never quite disappears."

Pailin province, where Samoeun lives, is the unwitting nursery of drug-resistant malaria. It "is the epicenter of strains of malaria that have baffled healthcare experts worldwide, raising fears a dangerous new form of malaria could already be spreading across the globe."

Last year, a study published by the New England Journal of Medicine "showed that conventional malaria-fighting treatments derived from artemisinin took almost twice as long to clear the parasites that cause the disease in patients in Pailin and others in northwestern Thailand, suggesting the drugs were losing potency in the area." USAID, a U.S. development agency, agrees that traditional arteminsinin-based therapies are "now taking two to three times longer to kill malaria parasites along the Thai-Cambodian border than elsewhere."

Three drug-resistant malaria parasites have emerged from this province over the past five decades. "Thanks to prolonged civil conflict, dense jungles and movement of mass migrants in the gem mines in the 1980s and 90s, the strains multiplied and dispersed through Myanmar, India and two eventually reached Africa."

"Few can say why it is a hotbed for drug-resistant malaria", but experts point to "a combination of sociological factors and a complicated history spanning the Khmer Rouge era when 1.7 million people, nearly a quarter of Cambodia's population, perished from execution, overwork or torture during their 1975-79 rule."

Insurgents clung to Pailin, and it was "one of their last holdouts" before their defeat in the late 1990s. During the era of the Khmer Rouge, people resided in Pailin illegally. When they contracted malaria, they bought medication through black markets and self-medicated.

Self-medication was the only way to curb the rising number of malaria cases, so Cambodia made the decision to make anti-malarial drugs available over the counter. "The strategy carried risks. Easy access reduced the number of cases but also led to incorrect dosages and substandard or counterfeit medicine". Instead of eradicating the malaria parasites, over-the-counter treatments made the parasitic population stronger against widely used medications.

Without adequate drugs to combat the disease, drug-resistant malaria parasites threaten the world. Preventative measures, such as the use of bed-nets to avoid mosquito bites, may be our best defense against malaria. Donate a bed net through Nothing But Nets.

Source:
Win, Thin Lei. Reuters. "Cambodia drug-resistant malaria stirs health fears." 6 March 2010.

Malaria enters the US

2010-03-05T09:23:00.002-05:00

"Nearly a dozen cases of Malaria has been confirmed here in the United States. All of the cases were acquired in Haiti after the January 12th, 2010 earthquake" (Gibbons). "Seven emergency responders, three Haitian residents now in the United States and one American traveler are known to have caught malaria in Haiti after the Jan. 12 earthquake, United States health officials said Thursday. Malaria is endemic throughout Haiti, so Haitians now living outdoors and relief workers are 'at substantial risk for the disease,' the Centers for Disease Control and Prevention said" (McNeil).

"Haiti already had a problem with malaria, which is spread by mosquitoes that will have more places to breed in the cities and towns wrecked by the giant quake" (Reuters). Displaced people living in temporary shelters our outdoors are at substantial risk of contracting malaria. Health workers who flooded to Haiti after the earthquake to offer aid are also at risk. "U.S. health officials advise people travelling to Haiti should take medications to prevent malaria" (UPI).

"Six out of eight patients, including seven emergency responders, had been advised to take drugs to prevent malaria but had not done so, the PAHO experts said." Three of the cases that the CDC cited "occurred among Haitian residents traveling to the United States and one case involved a U.S. resident who was visiting Haiti. All are expected to recover fully" (Reuters).

Individuals in Haiti are still at risk. "Each year, Haiti reports about 30,000 confirmed cases of malaria to the Pan American Health Organization, but the CDC estimates as many as 200,000 may occur each year. According to the CDC, malaria transmission peaks after the two rainy seasons -- November to January and again during May to June" (Reuters). The peak season is still months away, but anti-malarial medications are already needed to treat those who are infected and reduce the number of possible cases.

"There is no vaccine against the parasite that causes the illness[,] and it quickly evolves resistance against drugs"; however some drugs are known to treat and reduce malaria illness (Reuters).

The CDC indicates that "anyone traveling to Haiti should take drugs to help prevent infection" (Reuters).

Sources:
Gibbons, Sabrina. WSB News. "Malaria from Haiti Now in US." 4 March 2010.

McNeil, Donald G Jr. The New York Times. "U.S. Warns of Malaria Risk in Haiti". 4 March 2010.

Reuters. "Travelers from Haiti bringing Malaria to the US." 4 March 2010.

UPI. "Malaria Drugs for those going to Haiti." 4 March 2010.

Climate and behavioral change

2010-03-04T07:38:00.002-05:00

In recent years, "malaria has been spreading into highland areas of East Africa, Indonesia, Afghanistan, and elsewhere" it was previously unknown. High elevations, low temperature, and temperate rainy seasons prevented malaria from entering these regions before. Now, the deadly disease is contracted locally in these previously malaria-safe environments. Malaria "is on the rise in some parts of the world" partly due to climate change. Other "factors such as migration and land-use changes are likely also at play."

"We assessed...conclusions from both sides and found that evidence for a role of climate in the dynamics is robust," write study authors Luis Fernando Chaves from Emory University and Constantianus Koenraadt of Wageningen University in the Netherlands. "However, we also argue that over-emphasizing a role for climate is misleading for setting a research agenda, even one which attempts to understand climate change impacts on emerging malaria patterns."

"Malaria, a parasitic disease spread to humans by mosquitoes, is common in warm climates of Africa, South America and South Asia." Development and survival of the mosquito and parasite depend on warm temperatures; therefore, "the disease has been spreading to the highlands, and many studies link the spread to global warming. But that conclusion is far from unanimous. Other studies have found no evidence of warming in highland regions, thus ruling out climate change as a driver for highland malaria."

Most studies, which conclude that climate change plays a significant role in highland malaria, tend to be statistically strong. Clearly, climate change does impact the range of malaria endemic regions; however, it may not be the only contributing factor. "What is needed, the researchers say, is a research approach that combines climate with other possible factors."

"Even if trends in temperature are very small, organisms can amplify such small changes and that could cause an increase parasite transmission," a researcher said. "More biological data will improve our overall understanding of malaria and will allow scientists to propose more general and accurate models on the impacts of climate change on malaria transmission."

Some factors contributing to the spread of malaria may be migration and agriculture. People "migrating from lowlands may be introducing the malaria parasite into highland regions. Changes in farming practices may also play a role. Irrigation associated with more intensive farming may be creating more places for mosquitoes to breed."

"The spread of malaria in highlands is of great concern to those who work to contain the disease. But understanding the many factors that influence the spread of highland malaria could help with efforts to control the disease worldwide."

Source:
University of Chicago Press Journals (2010, March 4). Climate change one factor in malaria spread. ScienceDaily. Retrieved March 4, 2010, from http://www.sciencedaily.com /releases/2010/03/100303162906.htm

Anti-malarial treats cancer

2010-03-03T07:25:00.002-05:00

"Can a drug that has been used to treat malaria for years possibly be used to treat breast cancer before it becomes invasive? That's what researchers at George Mason University's Center for Applied Proteomics and Molecular Medicine (CAPMM) and Inova Breast Care Institute (IBCI) are trying to prove." We already know that artemisinin may target and kill cancer cells in breast-cancer patients, but now it appears that chloroquine, a drug commonly administered to treat malaria, may also treat cancer.

In a three-year clinical trial, researchers "will test the effectiveness of the anti-malarial drug chloroquine in treating 90 women with ductal carcinoma in situ (DCIS), a type of breast cancer in which the cancer cells start in the milk ducts but have not yet become invasive and spread in the breast. Once the cancer cells start to spread in the breast and throughout the body, the condition is considered invasive and can often be fatal."

Breast cancer is the most common form of cancer in women (American Cancer Society). In 2009, 254,650 patients were diagnosed. This treatment will "prevent breast cancer cells from becoming deadly by killing pre-invasive cancer cells". A novel therapy that uses chloroquine, which has been used to treat malaria in the past, may prevent deaths from breast cancer in the near future.

Source:
George Mason University (2010, March 2). Trial launched to test new treatment for pre-invasive breast cancer. ScienceDaily. Retrieved March 3, 2010, from http://www.sciencedaily.com¬ /releases/2010/03/100302123120.htm

Battling malaria

2010-02-20T10:21:00.004-05:00

"Scientists battling malaria have earned a major victory", according to a Nature Genetics study. "Combating malaria resistance is nothing short of an arms race," says author and pediatrics professor, Dr. Philip Awadalla, from the Universite de Montreal. "As the malaria pathogen evolves, researchers must evolve with it to find ways to counter the disease."

Every year approximately 250 million people contract malaria. "Malaria is transmitted when people are bitten by infected mosquitoes. According to the World Health Organization, malaria symptoms include fever, headaches, vomiting and appear within 10 to 15 days after an infected mosquito bite." If left "untreated, malaria can be life-threatening" and may kill "an estimated five million people yearly." At the current level of malaria treatment one million people die annually, and most of those who die are young children.

The team at Universite de Montreal is deciphering the deadly parasite in an effort to eradicate the disease. This "international group of researchers has used genomics [study of organisms' genomes] to decode the blueprint of Plasmodium falciparum -- a strain of malaria most resistant to drugs that causes the most deaths around the world. The discovery may lead to advanced pharmaceuticals to fight the disease and prevent drug resistance".

"The team decoded 200 malaria samples from Asia, Africa, Central America, South America and Papua New Guinea. Their goal was to identify how Plasmodium falciparum strains were becoming resistant to the eight anti-malaria drugs currently available." The team noted how there is "substantial genetic differences in malaria around the world. What has occurred is a combination of genetic drift, where genes segregated over space and time from differential environments, immune pressures and exposures to drugs."

Research discovered that "Plasmodium falciparum recombined fastest in Africa...New clues garnered by this study...will allow pharmaceutical companies to create treatments that target the evolving malaria genome."

Sources:

Mu et al. Plasmodium falciparum genome-wide scans for positive selection, recombination hot spots and resistance to antimalarial drugs. Nature Genetics, 2010; DOI: 10.1038/ng.528

University of Montreal (2010, February 18). Genomic warfare to counter malaria drug resistance. ScienceDaily. Retrieved February 20, 2010, from http://www.sciencedaily.com¬ /releases/2010/02/100216140146.htm

King Tut's Curse

2010-02-16T17:38:00.004-05:00

Celebrities draw attention to the diseases that ail them. This is true even if the celebrity is over three-thousand years old. Several media channels released reports pinning the death of King Tutankhamun, a famous pharaoh who died at a young age, on "a severe bout of malaria combined with a degenerative bone condition" (New York Times).

Results from the recent study of Tut's mummy show that he had several genetic bone disorders and that he was "afflicted with avascular bone necrosis, a condition in which diminished blood supply to the bone leads to serious weakening or destruction of tissue." In an already weakened individual, malaria is often fatal. "The finding led to the team's conclusion that it and malaria were the most probable causes of death" (New York Times).

Malaria was nearly impossible to escape during the time of King Tut. Mosquitoes bred in the Nile Valley, fed off whomever they encountered--royalty or not--and carried malaria. In modern times, approximately one million people die from malaria every year. Most of those who die are children, women, and already ill people. Today, a malaria-stricken individual can be treated for malaria. A variety of drugs combat the malaria parasites that cause illness in humans. Malaria can also be prevented through the use of insecticides, mosquito nets, and preventative medicines.

King Tut may not have been so lucky. While the pharaoh may have been able to hide from mosquitoes behind a bed net (a method of malaria prevention still used today), he did not have extensive medical treatments available to him--a fate that still befalls many today.

250 million cases of malaria are reported annually. Many of the humans who fall ill to malaria do not have the medical resources they need to survive. Over three-thousand years after Tut's death, people still suffer and die from malaria. But now, malaria is treatable and preventable. The problem is getting the necessary medical treatment to those in need.

My suggestion: Let the dead do what they do, and worry instead about the people dying today.

Support Roll Back Malaria and Malaria No More. Treating a bout of malaria costs under $5.00. A $10 bednet can save two lives.

Sources:
New York Times. Wilford, John Noble. "Malaria Most Likely Killed King Tut, Scientists Say." 16 February 2010.

Telegraph. Alleyne, Richard. "King Tut died of malaria and bone condition, says new research." 16 February 2010.

Credit: @followthethread deserves recognition for her alert. She's on my Do Not Bite list.

Photo source: Bjørn Christian Tørrissen (via wikimedia creative commons archives)

Chemical paths

2010-02-16T09:19:00.003-05:00

Frequent use and misuse of antimalarials [drugs that fight malaria] can lead to malaria parasites that are resistant to existing treatments. For this reason, there "is an urgent need for new drugs to combat malaria". "Researchers report that they have discovered -- and now know how to exploit -- an unusual chemical reaction mechanism that allows malaria parasites and many disease-causing bacteria to survive."

The same research team from the University of Illinois, led by Eric Oldfield, developed an inhibitor of a pivotal chemical reaction. This inhibitor may fight malaria [and other bacterial and parasitic diseases] in a manner that is different from the traditional medicines. The situation is dire, according to Oldfield. "The parasites that cause malaria also have become resistant to quinine, chloroquine and now, artemisinin, three common treatments for the disease."

"The new study focuses on an essential chemical pathway that occurs in malaria parasites and in most bacteria but not in humans or other animals, making it an ideal drug target." An enzyme, known as IspH, promotes the assembly of a "class of compounds, called isoprenoids, which are essential to life" and prove to be necessary to the bacteria and parasites that cause disease.

"Isoprenoids are the largest class of compounds on the planet," Oldfield said. "There are over 60,000 of them. Cholesterol is an isoprenoid. The orange beta-carotene in carrots is an isoprenoid. And bacterial cell walls are made using isoprenoids." After a decade of research, scientists believe that they understand the structure and function of IspH and hope that it will "allow them to find a way to... shut down production of isoprenoids in the disease-causing bugs," thereby reducing their numbers.

"We're really at the initial, key stage, which is understanding structure and function and getting clues for inhibitors -- drug leads," he said. "But there are a finite number of proteins unique to bacteria and malaria parasites that can be targeted for the development of new drugs. And everyone agrees that this enzyme, IspH, is a tremendous target."

Further research:
Eric Oldfield et al. Bioorganometallic mechanism of action, and inhibition, of IspH. Proceedings of the National Academy of Sciences, Feb 15, 2010. http://www.news.illinois.edu/WebsandThumbs/Oldfield,Eric/0215pnas.200911087.pdf
The National Institute of General Medical Sciences at the National Institutes of Health funded this research.

Source:
University of Illinois at Urbana-Champaign (2010, February 16). New weapon to fight disease-causing bacteria, malaria developed. ScienceDaily. Retrieved February 16, 2010, from http://www.sciencedaily.com¬ /releases/2010/02/100215173944.htm

Photo source:
http://insciences.org/article_album_file.php?article_id=8350&articlemedia_id=1069

Substandard Medicines

2010-02-12T12:05:00.001-05:00

"A high percentage of medicines circulating on national markets", in ten Sub-Saharan African countries, "are of substandard quality and thus may contribute to the growth of drug-resistant strains of Plasmodium falciparum, the most virulent form of malaria." First results of the "large-scale study of key antimalarial medicines" were released for Madagascar, Senegal, and Uganda by the Promoting the Quality of Medicines (PQM) Program, a USAID-funded program.

"Within Madagascar, Senegal and Uganda, the study" focused "on artemisinin-based combination therapy (ACT) products, currently the WHO's recommended form of first-line treatment for uncomplicated malaria, and sulfadoxine-pyrimethamine (SP) products, often used for preventative treatment of malaria during pregnancy." Researchers collected samples from "public and regulated private sectors" and from "informal markets, as many patients obtain their medicines from these sources."

"Substandard and counterfeit versions of antimalarial medicines are highly problematic throughout Africa, Asia and Latin America because of the direct threat they pose to the lives of individual patients as well as their contribution to the development of drug-resistant strains of these diseases." The "study found that approximately 44 percent of sampled medicines from Senegal, 30 percent of samples from Madagascar, and 26 percent of samples from Uganda that underwent full quality control laboratory testing failed such testing and were thus substandard."

"Substandard" medicines are classified as "those that do not meet the quality specifications set for them, primarily because they do not contain the correct amount of the active ingredient(s), do not dissolve properly in the body or include unacceptable levels of potentially harmful impurities." According to the released results, "[n]o samples in the full study completely lacked the active ingredient(s). The results also showed that, as a general rule, when a brand passed or failed in one country, it would also pass or fail in other countries. This indicates that the problem of quality is created at the source, rather than during passage through the distribution chain."

Substandard medicines were not limited to informal markets, and their point of sale varied by country. "In Madagascar, for instance, poor quality medicines appear to be widespread across regions and not limited to any particular type of distributor [public, private, or informal]. In Uganda, samples fared much better in the public sector than in the country's private sector. Despite overall failure rates, this was one of the bright spots the study revealed; in Uganda's public sector, all ACT and SP samples passed quality tests."

The purpose of this study was reveal "the prevalence of substandard antimalarials in Sub-Saharan Africa, which are believed to contribute to antimicrobial resistance of Plasmodium falciparum. Already, Plasmodium falciparum has become resistant to traditional" treatments "such as chloroquine, and more recently to SP products. The sustainability of treatment success depends to a large extent on preventing Plasmodium falciparum's exposure to incomplete doses of these medicines to minimize the possibility of the emergence of drug resistance."

Source:
US Pharmacopeia (2010, February 10). One-third of antimalarial medicines sampled in three African nations found to be substandard. http://vocuspr.vocus.com/vocuspr30/Newsroom/ViewAttachment.aspx?SiteName=USPharm&Entity=PRAsset&AttachmentType=F&EntityID=108111&AttachmentID=f2e22216-44a5-41a2-a9bc-464b7a98e3bf

Malaria vaccine to protect pregant women

2010-02-12T12:03:00.003-05:00

"Each year, 25 million pregnant women in sub-Saharan Africa run the risk of contracting malaria." Women who become infected during their first pregnancy are at the most risk for severe anemia and poor fetal growth. "The malaria parasites accumulate in the placenta, resulting in children being born prematurely and underweight." Maternal malaria causes the death of approximately 200,000 infants and 10,000 women each year

"Researchers at the University of Copenhagen have become the first in the world to synthesize the entire protein that is responsible for life-threatening malaria in pregnant women and their unborn children. The protein known as VAR2CSA enables malaria parasites to accumulate in the placenta and can therefore potentially be used as the main component in a vaccine to trigger antibodies that protect pregnant women against malaria. The research team is now planning to test the efficacy of the protein-based vaccine on humans."

"The hope is that within 10 years all African girls could be vaccinated against maternal malaria, thereby preventing more than 200,000 deaths a year." The vaccine "elicits antibodies that stop the [malaria] parasite from binding to the placenta." Laboratory testing is underway, and the vaccine can already be tested in animals.

"These antibodies seem to be effective at preventing the parasite from accumulating in the placental tissue. The next step is to investigate whether we can elicit the same antibodies and so protect against the disease by vaccinating humans. Then the vaccine will be a reality."

Source:
University of Copenhagen (2010, February 5). Vaccine to protect pregnant women from contracting malaria?. ScienceDaily. Retrieved February 12, 2010, from http://www.sciencedaily.com /releases/2010/02/100204144433.htm

Pregnant women at risk

2010-02-09T07:38:00.000-05:00

Pregnancy, for most women, means planning for a safe and healthy baby, but in malaria-endemic regions, fear of mortality outweighs hope. At "least 125.2 million women" who are at risk of contracting malaria "become pregnant each year".

Malaria during pregnancy creates disaster, causing "miscarriages, preterm births," low-birth-rate, and death. "About 10,000 women and 200,000 babies die annually because of malaria" during pregnancy. "Most malaria deaths are caused by Plasmodium falciparum, which thrives in tropical and sub-tropical regions", but "the most widespread type of malaria is P. vivax malaria, which also occurs in temperate regions." Estimates on the burden of malaria were previously only available for Africa", but now include lesser-realized endemic regions.

"The researchers estimated the sizes of populations at risk of malaria in 2007 by combining maps of the global limits of P. vivax and P. falciparum transmission with data on population densities. They used data from various sources to calculate the annual number of pregnancies (the sum of live births, induced abortions, miscarriages and still births) in each country. They calculated the annual number of pregnancies at risk of malaria in each country by multiplying the number of pregnancies in the entire country by the fraction of the population living within the spatial limits of malaria transmission in that country."

"This study contributes to the global understanding of the risk of malaria in pregnancy. In 2007, 54.7 million pregnancies occurred in areas with stable P. falciparum malaria and a further 70.5 million in areas with exceptionally low malaria transmission or with P. vivax only. This marks the first time species specific risks have been estimated globally for malaria in pregnancy."

Source:
Dellicour S, Tatem AJ, Guerra CA, Snow RW, ter Kuile FO. Quantifying the Number of Pregnancies at Risk of Malaria in 2007: A Demographic Study. PLoS Medicine, 2010; 7 (1): e1000221 DOI: 10.1371/journal.pmed.1000221

Lost Code

2010-02-07T09:42:00.004-05:00

Although made of few parts, the complete DNA content or genome of a species is extensive and complicated. Plasmodium falciparum, "the most deadly form of malaria", has about 5,300 genes. "Up until now, scientists [had] a good understanding of the gene functions for only about half" of the genes.

Plasmodium falciparum is a tiny parasite that infects the blood of mammals through mosquito bites and is responsible for approximately 1 million human deaths each year. "Using transcriptional profiling," a process by which "gene expression (activity) patterns" are revealed, the research team lead by Prof Zbynek Bozdech (Nanyang Technological University) "has successfully uncovered the gene functions for almost the entire genome, with more than 90 percent of the gene functions from the previously unknown half now better understood."

"Transcriptional profiling is the measurement of the activity of thousands of genes at once," in order to "create a global picture of cellular function. These profiles can, for example, distinguish between cells that are actively dividing, or show how the cells react to a particular treatment. This outcome in infectious disease pathology could potentially be the decade's big breakthrough as it has yielded critical information about how the malaria parasite...responds to existing compounds with curative potential."

"Preventing malaria infection is important because resistance to anti-malaria drugs is a growing problem worldwide. There is currently no vaccine for malaria, which is widespread in poorer countries where it remains a hindrance to economic development. Also of growing concern to scientists is the confirmation of the first signs of resistance to the only affordable treatment left in the global medicine cabinet for malaria: Artemisinin."

"In successfully using transcriptional profiling to study the behavior of the malaria parasite, ...researchers have ventured into the unknown and paved the way for future breakthroughs in healthcare."

Sources:
Gastin, George. "GenomeGradient.jpg" [Photo hosted by wikimedia, shared under CC license] http://commons.wikimedia.org/wiki/File:Genome_gradient.jpg

Nanyang Technological University (2010, February 6). World's first in-depth study of the malaria parasite genome. ScienceDaily. Retrieved February 7, 2010, from http://www.sciencedaily.com /releases/2010/02/100205102607.htm

Protective immunity

2010-02-06T10:17:00.002-05:00

Every year approximately a million people die from malaria, a treatable blood disease, and most of those who die are children under the age of five. "A new vaccine to prevent the deadly malaria infection has shown promise to protect the must vulnerable patients--young children--against the disease."

The results found by the international research team, led by the University of Maryland School of Medicine's Center for Vaccine Development (CVD) and the Malaria Research and Training Center at the University of Bamako in Mali, excites the medical community. "In a new study of the vaccine in young children in Mali, researchers found it stimulated strong and long-lasting immune responses. In fact, the antibody levels the vaccine produced in the children were as high or even higher than the antibody levels found in adults who have naturally developed protective immune responses to the parasite over lifelong exposure to malaria."

"In areas of the world such as Africa, where malaria is particularly rampant, the young are most vulnerable to the disease since they have not built up the same natural immunity as adults. A child dies of malaria every 30 seconds, according to the World Health Organization. There are about 300 million malaria cases worldwide each year, resulting in more than one million deaths, most of them African children."

Malaria is a parasite, "spread to humans through mosquito bites". At this time, "no approved vaccine to protect against the condition" exists, although "using bed nets or killing mosquitoes with insecticides can prevent infection. The parasite is treatable using medications, though drug resistance is a relatively common problem. Eradicating the disease has become a priority for scientists and health officials worldwide. An effective and broadly protective vaccine is a key step toward that goal."

This "vaccine, based on a single strain of the falciparum malaria parasite -- the most common and deadliest form of the parasite found in Africa -- targets malaria in the blood stage. The blood stage is the period after the mosquito bite, when the parasite multiplies in the blood, causing disease and death." Before this discovery, "other blood stage vaccines" existed, but none of them exhibited "the ability to prevent malaria disease."

In addition to preventing malaria, the vaccine (at all three tested doses) "proved to be safe and well tolerated" in each of the 100 Malian children administered with the drug. A new trial is already planned to test more subjects and to examine "whether the vaccine -- though it is based on a single strain of malaria -- can protect against the broad array of malaria parasites that exist."

Sources:
University of Maryland Medical Center (2010, February 6). New malaria vaccine is safe and protective in children, scientists find. ScienceDaily. Retrieved February 6, 2010, from http://www.sciencedaily.com /releases/2010/02/100203201425.htm

Lethal Weapon

2010-02-03T07:35:00.002-05:00

"Mankind may finally have a weapon to fight two of the world's deadliest diseases." A new vaccine may prove to be a "lethal weapon against malaria" and cholera. Each year approximately a million people die from malaria and cholera sickens hundreds of thousands. Currently, "no FDA approved vaccine to prevent malaria, a mosquito-borne illness" exists. "Only one vaccine to fight cholera, a diarrheal illness that is common in developing countries and can be fatal" is on the market. "The lone vaccine is too expensive to prevent outbreaks in developing countries after floods, and children lose immunity within three years of getting the current vaccine."

Recently, a "University of Central Florida biomedical researcher has developed what promises to be the first low-cost dual vaccine against malaria and cholera."

Led by Henry Daniell, the "team genetically engineered tobacco and lettuce plants to produce the vaccine. Researchers gave mice freeze-dried plant cells (orally or by injection) containing the vaccine. They then challenged the mice with either the cholera toxin or malarial parasite…Untreated rodents contracted diseases quickly, but the mice who received the plant-grown vaccines showed long-lasting immunity for more than 300 days (equivalent to 50 human years)."

In addition to this vaccine, Daniell's lab has "created vaccines against anthrax and black plague that generated a congratulatory call from the top U.S. homeland security official and was featured on the Discovery Channel."

But, why lettuce? "Producing vaccines in plants is less expensive than traditional methods because it requires less labor and technology," Daniell said.

"We're talking about producing mass quantities for pennies on the dollar," he said. "And distribution to mass populations would be easy because it could be made into a simple pill, like a vitamin, which many people routinely take now. There is no need for expensive purification, cold storage, transportation or sterile delivery via injections."

"For Daniell, his research is more than his day job. His passion to find vaccines for the world's top 10 diseases as defined by the World Health Organization comes from growing up in India. He watched many of his childhood friends contract malaria, cholera and other diseases."

"I'm not done yet," he claims. "I still have more diseases to attack."

Source:
University of Central Florida (2010, January 27). New vaccine could be lethal weapon against malaria, cholera. ScienceDaily. Retrieved February 3, 2010, from http://www.sciencedaily.com¬ /releases/2010/01/100126101421.htm

Digestive enzymes

2010-01-31T08:36:00.002-05:00

"Malaria causes more than two million deaths each year, but an expert multinational team battling the global spread of drug-resistant parasites has made a breakthrough in the search for better treatment" (McGill). Examining the way malaria parasites reproduce, a team led by John Dalton, has identified "a plan of attack" to develop new and urgently needed treatments, which combat malaria.

The secret lies in how the parasites propagate. "Malaria parasites live inside our red blood cells and feed on proteins". They break down the proteins to "use the proceeds (amino acids) as building blocks for their own proteins". Once they "a sufficient size they divide and burst out of the red cell, entering another and repeating the process until severe disease or death occurs."

Specialized digestive enzymes of the parasites "enable them to undertake this process." Researchers have now developed three-dimensional structures of these two enzymes and "demonstrated how drugs can be designed to disable the enzymes."

"By blocking the action of these critical parasite enzymes, we have shown that the parasites can no longer survive within the human red blood cell," Dalton explains. "The team is putting their findings into action immediately and is already pursuing anti-malarial drug development."

Publications: The discovery will be published in the Proceedings of the National Academy of Sciences, and is the result of collaboration including Australia’s Queensland Institute of Medical Research, Monash University and the University of Western Sydney, Wroclaw University of Technology in Poland and the University of Virginia in the U.S.

Read more about digestive enzymes and malaria

Source:
McGill University (2010, January 29). Breakthrough could lead to new treatment for malaria. ScienceDaily. Retrieved January 31, 2010, from http://www.sciencedaily.com¬ /releases/2010/01/100128165850.htm

Haiti in the wake of disaster

2010-01-16T09:39:00.006-05:00

"Tuesday's earthquake could decimate what fragile medical care exists" in Haiti "and spawn a 'perfect storm' in a country already struggling to fight rare tropical and infectious diseases, health experts" warn. The Red Cross has estimated that "3 million people -- one-third of Haiti's population -- were affected by the quake", which was measured at a magnitude of 7.0 and "ripped apart buildings, shearing huge slabs of concrete off structures in the poorest country in the Western Hemisphere" (Park). The homeless are "clustering in public places without food, clean water or sanitation. It's the perfect environment for the spread of communicable disease." Photo by Pinheiro.

The earthquake has thwarted medical efforts in a place that already struggles to stave off infectious diseases. "Even before the earthquake, the country has been the subject of intense public health efforts, as nearly half the causes of deaths have been attributed to HIV/AIDS, respiratory infections, meningitis and diarrheal diseases, according to the World Health Organization." "Hundreds of thousands of people are sleeping in tents, or filling public squares waiting for some kind of help. There is no water, food or sanitation. Many of the survivors have broken arms and legs" (Kenny). "The earthquake decimated Haiti's capital just days ago[, but] it's an eternity in terms of getting medical care to the injured" (Pearson). Now, "if left untreated, minor injuries or fractures can become life-threatening because they're left open to bacterial infections such as tetanus".

Even the uninjured face severe medical risks.

"The disaster cut power, electricity and other utilities." Without clean drinking water, endemic diseases are hard to resist. "What you have is the perfect storm of infection. What you have is a breakdown. It is already a fragile infrastructure with high rates of infectious and neglected tropical disease. Now there are potential breakdowns in sanitation, clean water, housing and subsequent crowding. That's a terrible mix," says Dr Peter Hotez, head of the department of microbiology at George Washington University. "The potential new mass of displaced persons could create crowded, unsanitary conditions that facilitate the spread of contagious respiratory infections."

Cholera, typhoid fever, and other diarrheal diseases threaten the people. "Bacterial and mosquito-borne diseases such as dengue and malaria" are also major risk factors to the injured and uninjured alike.

Dirty water, broken drainage, and a tattered terrain create natural reservoirs where disease can breed. Malaria, an infectious disease that kills approximate one million people each year and is carried by mosquitoes, is expected to intensify in the aftermath of the quake. Malaria is already endemic in this region, and in the midst of this chaos, it will be difficult to avoid.

Doctors "worry that the major, long-term health initiatives to treat preventable diseases" like malaria and dengue "could be upended" by this disaster. "Any interruptions in fighting these preventable diseases has disastrous consequences", claims Hotez. "This is going to a big setback for public health control measures, and you will see the impact of this earthquake at least for months and possibly for years." Kaplan, who formed the Cap Haitien Health Network to tackle preventable diseases such as diarrhea, malaria and malnutrition agrees, "That's another tragedy of the earthquake."

"When the rubble is cleared and the bodies are buried," Haiti will still face the threat of devastating disease as it always has. But by that time, medical supplies and money will be expended on the newly injured, clinics and hospitals will need to rebuild, and the landscape will need to be reshaped in order to prevent water buildup, which fuels the spread of infectious diseases.

Despite it all, Kaplan has hope. He hopes that "this situation may lead to improvements, because it's bringing lots of attention and help to the area." "There's that silver lining," he said.

Want to help the relief & malaria prevention effort in Haiti? Support the Red Cross.
Send a $10 Donation by Texting 'Haiti' to 90999
You may also call 1-800-REDCROSS to make a donation over the phone.
Please DO NOT send donations for Haiti relief efforts to Infectious Bite. Donations to support the Infectious Bite malaria awareness campaign are always welcome.

Sources:
Kenny, Sean. Common Dreams. "Haiti's earthquake survivors face massive risk."
Park, Madison. CNN.com. "Haiti's earthquake could trigger 'Perfect Storm'." 13 January 2010.
Pearson, Carol. VOA News. "In Haiti, Wounds, Infectious Diseases are top concern." 15 January 2010.
Pinheiro, Roosewelt. Agência Brasil. [PHOTO]

Who ya gonna call?

2010-01-13T07:44:00.004-05:00

Blood-drinkers be warned: Slayers are on the prowl. Taking a note from a cheesy '80s movie, these hunters have equipped themselves with a backpack-carried weapon and are crawling the sewers collecting the flying fiends who annoy the living.

Mosquito hunters from Emory University have developed an efficient way to monitor adult mosquitoes and the deadly diseases they carry, and they have done it cheaply. "Emory has filed a provisional patent on the Prokopack mosquito aspirator, but the inventors have provided simple instructions for how to make it in the Journal of Medical Entomology."

"This device has broad potential, not only for getting more accurate counts of mosquito populations, but for better understanding mosquito ecology," according to Gonzalo Vazquez-Prokopec. "There is a great need for effective and affordable mosquito sampling methods. Use of the Prokopack can increase the coverage area, and the quality of the data received, especially for blood-fed mosquitoes. Ultimately, it can help us develop better health intervention strategies."

This new invention outperformed standards for resting mosquito surveillance in lab and field tests. The Prokopack has a longer reach than the Center For Disease Control and Prevention Backpack Aspirator (CDC-BP), which enables "it to collect more mosquitoes than the CDC-BP". The Prokopack is also "significantly smaller, lighter, cheaper, and easier to build" than its predecessor.

"Anyone with access to a hardware store, and about $45 to $70, can make the Prokopack, which uses a battery-powered motor to suck up live mosquitoes for analysis."

"The CDC-BP can quickly vacuum up samples of live specimens, which can be analyzed in a lab to determine the source of blood they recently consumed. The drawbacks to the CDC-BP, however, include its heavy weight (26 pounds), its bulk and its price -- about $450 to $750 in the United States."

"With a bit of ingenuity and a few trips to the hardware store," the Emory research team "put together a solution: a plastic container, a wire screen, a plumbing pipe coupler, a battery-powered blower motor and painter extension poles. After some experimentation with these components, the Prokopack was born.

"Collecting more mosquitoes in higher locations can give researchers more insights into their behaviors. Upper foliage, for instance, can yield more mosquitoes resting after feeding on birds. And upper walls and ceilings of homes may harbor more mosquitoes resting after a meal on humans."

Source:
Emory University (2010, January 13). Mosquito hunters invent better, cheaper, DIY disease weapon. ScienceDaily. Retrieved January 13, 2010, from http://www.sciencedaily.com¬ /releases/2010/01/100112152402.htm

Alarm amid medicine shortage

2010-01-08T07:36:00.001-05:00

Kenya's rainy season is the most dangerous for contracting malaria, a deadly disease carried by mosquitoes, and children are the most susceptible. "A shortage of malaria drugs for children has hit hospitals as fears of an outbreak of the disease loom following heavy rains in various parts of the country."

"The Kenya Medical Supplies Agency said stocks of the drugs were running low, but were in the process of being procured and could be delivered by the beginning of February." The Chief executive, John Munyu, is hopeful that the crisis will be avoided because deliveries are continuing. He indicated that "adult malarial drugs are already being supplied after a reported shortage in parts of the country."

The minister of medical services, Anyang' Nyong'o, claims that "the shortage of drugs was caused by inadequate funding by the Treasury." The "budget for Health ministries was laughable when compared to that for the Ministry of Education", he says. This is not the first shortage that Kenya has suffered in recent years. Antibiotics used to treat cholera "were nearly exhausted due to last year's outbreak".

Still, Nyong'o is confident that disaster will be avoided. He says, "I do not envisage any crisis because the government is already adding stocks to what is already there in the health facilities. That is mere replenishment."

Ogo, Kenneth. "Children's malaria drugs run out." Daily Nation. 7 January 2010.

Critically weakened

2010-01-03T22:24:00.001-05:00

What happens when a vampire does not feed on human blood?

If you believe the tales spun in Vampire Diaries, then the once-deadly creature becomes significantly weakened, looses the ability to affect the human brain, and is generally much less threatening than his human blood consuming counterpart. The same is true for the variety of parasite that Dr Andrea Crisanti is studying in an attempt to find a malaria vaccine.

Malaria, a mosquito-borne disease that affects 300-500 million people each year, is caused by infection with Plasmodium parasites. The deadly disease kills approximately one million people every year, most of whom are children and pregnant women, is treatable and preventable. The search for a malaria vaccine is well under way, but the "number of life cycle changes" that the parasites undergo increase "the challenges of malarial vaccine development." In other words, because the malaria parasites change and adapt rapidly, a workable vaccine is difficult to develop.

However, recent research by Crisanti and her colleagues "have found that weakened Plasmodium elicits a protective immune response." This means that clinically and genetically weakened parasites may be used for vaccine development. Crisanti's team targeted Plasmepsin 4, "a digestive enzyme that is critical for Plasmodium growth and survival within the host red blood cells." Research showed that parasites without the critical digestive enzyme "were significantly less virulent than their wild-type [define: normal] counterparts."

Furthermore, "infection with plasmepsin 4-deficient parasites, in contrast to infection with wild-type Plasmodium, did not induce cerebral complications", which means that infection with the weaker parasite produces a less severe illness than an ordinary malaria infection. Also, parasites without the digestive enzyme "induced strong protective immune responses against secondary immunization with wild-type Plasmodium." This weakened parasite may provide a model for comparing genetically-weakened malarial vaccines.

Dr. Crisanti and colleagues conclude that "it is possible, by engineered inactivation of parasite proteins, to generate attenuated blood stage parasites that are capable of inducing protective immunity against blood-stage infection. Such parasites should be powerful tools in elucidating parasite-derived factors that cause severe disease and should provide additional insight into factors that are required to induce protective immunity."

Source:
American Journal of Pathology (2009, December 31). Weakened Plasmodium generates protective immunity. ScienceDaily. Retrieved January 3, 2010, from http://www.sciencedaily.com¬ /releases/2009/12/091230193211.htm

Meddling with sex

2009-12-27T22:00:00.001-05:00

Your mother may have told you that it's not nice to meddle in the business of others (especially when it's 'nasty business'), but when it comes to mosquitoes, meddling may offer very nice results. Imperial College recently released a report, entitled: "Meddling in mosquitoes' sex lives could stop the spread of malaria", revealing how a particular species of Anopheles gambiae has an easily disrupted sexual process, which when interrupted will prevent that mosquito from breeding.

"The new study focuses on the species of mosquito primarily responsible for the transmission of malaria in Africa, known as Anopheles gambiae. These mosquitoes mate only once in their lifetime, which means that disrupting the reproductive process offers a good way of dramatically reducing populations of them in Africa. When they mate, the male transfers sperm to the female and then afterwards transfers a coagulated mass of proteins and seminal fluids known as a mating plug" (Reeves). Prior to the release of this study, the purpose of this mating plug was misunderstood. Unlike similar substances in other species, the "male mating plug is not a simple barrier to insemination from rival males" (Imperial). Instead it is "essential for ensuring that sperm is correctly retained in the female's sperm storage organ, from where she can fertilise eggs over the course of her lifetime. Without the mating plug, sperm is not stored correctly, and fertilisation cannot occur" (Reeves).

"In Imperial's mosquito labs, the scientists showed it was possible to prevent the formation of the plug in males, and that this stopped them successfully reproducing with females" (Imperial). "In the future", researchers may "develop an inhibitor that prevents the coagulating enzyme doing its job inside male An. gambiae mosquitoes in such a way that can be deployed easily in the field -- for example in the form of a spray as it is done with insecticides". In this way, "we could effectively induce sterility in female mosquitoes in the wild. This could provide a new way of limiting the population of this species of mosquito, and could be one more weapon in the arsenal against malaria" (Reeves).

Sources:
Imperial College London. "Meddling in Mosquitoes' Sex Lives Could Help Stop the Spread of Malaria." ScienceDaily 22 December 2009. 27 December 2009 .
Reeves, Danielle. "Meddling in Mosquitoes' Sex Lives Could Help Stop the Spread of Malaria." Imperial College London. http://www.eurekalert.org/pub_releases/2009-12/icl-mim121609.php

Malaria in Zanzibar

2009-12-17T23:17:00.004-05:00

Zanzibar, a" semi-autonomous region composed of two islands off the coast of Tanzania in East Africa," has "drastically reduced malaria" in the past decade. "Zanzibar's aggressive campaign against malaria has reduced infections from as much as 40 percent of its 1.2 million people to less than 1 percent." Recent concerns regarding the reintroduction of malaria to the region sparked a study that tracks the travel patterns of Zanzibar residents by their telephone reception.

"University of Florida researchers at work on a malaria elimination study in Africa have become the first to predict the spread of the disease using cell phone records." Without accessing personal information, "scientists analyzed more than 21 million calls to determine how often residents of Zanzibar travel and where they go." The researchers discovered that "short trips to Dar es Salaam on the Tanzanian mainland nearby, where malaria is relatively uncommon", dominated the travel patterns. "However, they also revealed that a few" Zanzibaris "travel back and forth from more distant areas of Tanzania where the risk of getting the disease is much higher -- posing the greatest threat to elimination."

"Most callers never left Zanzibar, which means they posed no threat of reintroducing the Malaria parasite...About 12 percent did leave the islands, but most of those only visited relatively safe Dar es Salaam, and usually for just one or two days at a time. However, a few hundred residents made trips to regions of western and southern parts of Tanzania, where as many as 40 percent of the residents have the malaria parasite."

Zanzibar has made huge advances against malaria in the past decade; however, those advancements may be reversed by reintroduction. Tanzania, including distant areas that are infected with malaria, must reduce malaria transmission in order to keep infections in Zanzibar low. With concerted effort across Tanzania, the country may eliminate malaria from within its borders.

Sources:
University of Florida. "Cell Phone Records Used to Predict Spread of Malaria." ScienceDaily 17 December 2009. 17 December 2009 .

Eco-epidemiology

2009-12-05T09:19:00.001-05:00

Small bands of males chased game through the savannahs. Females dug along the forest edges for roots, and searched the bushes for edible berries. Humans lived in isolated groups, which constantly moved in search of better subsistence. Then around ten thousand years ago, human settlements sprouted in the plains. Flocks grazed in pastures and humans tended their fields. This social transition "from hunting to agriculture brought permanent settlements, domestication of animals, and changes in diet. It also brought new infectious diseases, in what scientists call an 'epidemiologic transition'" (University).

"Another of these" epidemiologic "transitions came with the Industrial Revolution. Infectious diseases decreased in many places while cancer, allergies and birth defects shot up" (University). Changes to the environment, including shifts in the variety and type of species in a location, cause the emergence of new diseases or the resurgence of old diseases that were once rare.

"Now, it seems, another epidemiologic transition is upon us. A host of new infectious diseases -- like West Nile Virus -- have appeared. And infectious diseases thought to be in decline -- like malaria -- have reasserted themselves and spread" (University). Humans across the globe are falling victim to malaria, an ancient infectious disease, which was once considered to be limited to isolated tropical regions.

According to Pongsiri, a scientist conducting research on the resurgence of infectious disease, the studies "show that emergence or reemergence of many diseases is related to loss of biodiversity." She asserts that this disturbing trend is "not just case-study specific". "Something is happening at a global scale" (University). For example, it is now known that malaria rises and spreads from deforestation. The clearing of forests results in changes to the watershed, including the creation of reservoirs where malaria-carrying mosquitoes can breed. Elevation in regional temperature due to pollution or deforestation can increase the potential habitat of the mosquitoes, causing the disease to spread.

"It is new to think about biodiversity -- and therefore, species and land conservation -- as integral to public health. Until recently, almost no epidemiologists, nor medical schools, were framing questions of human infectious disease prevention in terms of, say, habitat structure, promoting genetic diversity in non-human species, or protecting animal predators as ecosystem regulators. Human diseases, goes the conventional thinking, are best understood and treated by looking at humans."

"Now there is the beginning of a movement to bring epidemiology and ecology together," says Pongsiri.

More info: http://www.sciencedaily.com/releases/2009/12/091203132157.htm

Source:
University of Vermont. "Biodiversity Loss Can Increase Infectious Diseases in Humans." ScienceDaily 3 December 2009. 5 December 2009 .

World AIDS Day

2009-12-01T00:03:00.002-05:00

"Malaria and HIV are two of the most devastating global health problems of our time. Together they cause more than 4 million deaths a year" (WHO). On this World AIDS Day, Infectious Bite looks at the relationship between malaria and HIV (the virus that causes AIDS), and discusses new research to treat co-infected (simultaneously infected with both diseases) individuals.

"Our current understanding of the human immune response to malaria and HIV leads us to expect that either infection might influence the clinical course of the other." Ordinarily, "infections are associated with at least a transient increase in HIV viral load" (measure of severity) and it is logical to assume that malaria accelerates "HIV disease progression." On the other side, "immune deficiency caused by HIV infection should, in theory, reduce the immune response to malaria parasitemia and therefore increase the frequency of clinical attacks of malaria" (Whitworth).

According to UNICEF, "HIV infection increases the incidence and severity of clinical malaria. In non-pregnant adults, HIV infection has been found to roughly double the risk of malaria parasitemia and clinical malaria...Although the effect of malaria on HIV has not been so well documented, some recent research is now adding to the growing body of evidence. Acute malaria infection increases viral load, and one study found that this increased viral load was reversed by effective malaria treatment. This malaria-associated increase in viral load could lead to increased transmission of HIV and more rapid disease progression, with substantial public health implications" (UNICEF).

Treatment of malaria is also complicated by HIV. "Artemisinin combination therapy has become the standard of care for uncomplicated malaria in most of Africa. However, there is limited data on the safety and tolerability of these drugs, especially in young children and patients co-infected with HIV" (Shereen). Recently, a "controlled trial was conducted" in Uganda consisting of "HIV-infected and uninfected children aged 4-22)." Participants were randomly designated to receive treatments of artemether-lumefantrine (AL) or dihydroartemisinin-piperaquine (DP). Both therapies were deemed "safe and well tolerated for the treatment of uncomplicated malaria in young HIV-infected and uninfected children" (Shereen).

In conclusion, co-infection of HIV and malaria fuels the spread of both diseases. HIV increases the severity of the episode and the patient susceptibility to malaria infection. Malaria increases the viral load of HIV, thereby elevating the risk of spreading HIV. "Co-infection might...have facilitated the geographic expansion of malaria in areas where HIV prevalence is high. Hence, transient and repeated increases in HIV viral load resulting from recurrent co-infection with malaria may be an important factor in promoting the spread of HIV in sub-Saharan Africa" (Abu). The connection between HIV and malaria also corresponds to the treatment of both diseases. Artemether-lumefantrine and dihydroartemisinin-piperaquine are safe for the treatment of malaria in HIV-infected children. It is also believed that the effective treatment of malaria within HIV-infected individuals may reverse the increased viral load of co-infected individuals.

SOURCES:
Abu-Raddad, Laith J. Et. Al. "Dual Infection with HIV and Malaria Fuels the Spread of Both Diseases in Sub-Saharan Africa". Science 8 December 2006.

Shereen, Katrak Anne. Et al. Malaria Journal 2009, 8:272
UNICEF. "Malaria and HIV/AIDS." http://www.unicef.org/health/files/UNICEFTechnicalNote6MalariaandHIV.doc

Whitworth, James. HIV InSite Knowledge Base Chapter. May 2006. http://hivinsite.ucsf.edu/InSite?page=kb-05-04-04

WHO. http://apps.who.int/malaria/malariandhivaids.html

Pirate parasites

2009-11-27T05:45:00.004-05:00

Parasitic Plasmodium invaders swarm the bloodstream, set up a base camp in the liver, and commandeer healthy red blood cells. These parasites "enter the body from the saliva of a mosquito" and send plague upon their victim (American). Malaria, the deadly and devastating disease that kills nearly a million people every year, is caused by the Plasmodium parasites as they pillage the human body for their own reproduction and survival.

"Inside the blood cells" of the malaria patient, "the parasites replicate and also begin to expose adhesive proteins on the cell surface that change the physical nature of the cells in the bloodstream" (American). Medical experiments "show that infected red blood cells are stiffer and stickier than normal ones." In "later stages of the disease" the cells can be "up to 10 times stiffer" than healthy red blood cells. These infected cells may also anchor onto "endothelial cells lining the vasculature, affecting the normal blood flow. This explains some of the common symptoms of malaria, such as anemia and joint pain" (American).

The parasites avoid a whirlpool of blood cell death in the spleen by anchoring in the safe harbors of the blood vessels. "Sticking to the walls of blood vessels is a survival mechanism for the parasite. In order to develop completely, it needs several days inside a red blood cell. Even though parasitized cells are nearly invisible for the immune system, they may be destroyed in the spleen while circulating freely in the bloodstream" (American).

Brown University professor George Karniadakis and student Dmitry Fedosov study "how malaria infections affect the physical properties of red blood cells, and alter normal blood flow circulation. In particular, they examine an increase in blood flow resistance, and dynamics of infected cells in the bloodstream." The properties that they measure are "used in modeling the flow of red blood cells in people infected with malaria" (American).

Fedosov says, "Our model predicts the dynamics of malaria-infected RBCs in the bloodstream, which anticipates the possible course of the disease." Each infected human contains a slightly different map and provides a unique environment that the parasites must navigate. The researchers recently discovered "that temperature fluctuations of infected red blood cell membranes measured in experiments are not directly correlated with the reported cell properties, hence, suggesting significant influence of metabolic processes" (American).

Hypothesizing on the metabolic processes that affect the patients' body temperatures, the researchers "measured an increase in resistance to blood flow in the capillaries and small arterioles during the course of malaria and found that parasitized red blood cells have a "flipping" motion at the vessel wall that appears to be due to stiffness of the infected cells. The developed models will aid to make realistic predictions of the possible course of the disease, and enhance current malaria treatments" (American).

Play the parasite game (NobelPrize.org site), and see if you can navigate your way to the liver.

Sources:
American Institute of Physics. "Measuring and Modeling Blood Flow in Malaria." ScienceDaily 22 November 2009. 27 November 2009 .

Call to action

2009-11-24T11:09:00.002-05:00

"In this week's PLoS Medicine, the journal's editors call for concerted international action to address the crisis of malaria drug shortages across Africa." Compared to activism for many other causes, anti-malaria offensives are still developing to find novel ways to fight the disease. Editors reveal the signs of "an evolving 'malaria activism' (akin to AIDS activism)" (Public). "Probably no other disease in human history has been associated with social and political activism to the extent that the HIV epidemic has" (AIDS Activism). "Such activism played a huge role in reducing the costs of antiretroviral drugs in developing countries" (PLoS). Five years ago, a strong voice "argued that similar activism was needed to raise awareness of shortfalls in global efforts to control malaria" (Yarney). "We believe there are now signs of an evolving "malaria activism," which has resulted in two major successes" (PLoS). These outspoken agents assert that two waves of malaria activism have already occurred, and that we stand on the break of a third wave which will help deliver life-saving drugs to those who need them.

According to the medical journal, the "first wave of malaria activism highlighted the gap between the huge burden of malaria and the tiny amount of international development assistance dedicated to its control. Such advocacy helped motivate donors to increase their malaria commitments." The second wave of activism "focused on making sure that the extra funding was used to purchase" combination therapy drugs (like artemisinin combination therapies) that are more effective in Africa than single drug therapies (like cholorquine).
"These are big victories," the editors declare. "But one benchmark of successful ACT [Artemisinin Combination Therapy] scale-up is whether the drugs are available at the point of care. One of us has just returned from a health reporting fellowship in East Africa, where he found that ACT 'stock-outs' (shortages) were common." This crisis is due in part to "inadequate funding" to purchase the necessary combination therapies, "delays in procuring the drug, and weak health information systems that can't properly track national drug needs and flows".
The editors of the medical journal call for action. It is time for a third wave of activism. This new wave will raise awareness of the shortages of necessary drugs in regions of the world where they are desperately needed.

Sources:
AIDS Activism. http://www.albany.edu/sph/AIDS/activists.html

PLoS. "Time for a Third Wave of Malaria Activism." http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000188

Public Library of Science. "It's Time for a 'Third Wave' of Malaria Activism to Tackle Drug Shortages." ScienceDaily 23 November 2009. 24 November 2009 .

Yarney, G. "Roll Back Malaria." http://www.plosmedicine.org/article/findArticle.action?author=Yamey&title=Roll%20Back%20Malaria:%20A%20failing%20global%20health%20campaign.

Male infertility

2009-11-18T09:51:00.002-05:00

How does male sterility combat malaria? When mosquitoes are sterile, they devastate the entire mosquito population. Called the Sterile Insect Technique (SIT), "the release of sexually sterile male insects to wipe out a pest population" is suggested as a "solution to the problem of malaria in Africa" (BioMed).

Malaria "control in sub-Saharan Africa, where 90 percent of the 300 to 500 million malaria cases and one to three million deaths occur from malaria each year, still depends on only two technologies for vector intervention: indoor residual spraying and insecticide-treated bed nets" (Klassen). Overtime mosquitoes become resistant to pesticides and insect populations bounce back from elimination efforts. According to researcher, Mark Benedict, "In the context of elimination, SIT could play a unique role. As part of an area-wide integrated pest management programme, the SIT may be able to minimize problems due to insecticide resistance to antimalarial drugs" (BioMed).

This technique "involves the generation of 'sterile' male mosquitoes, which are incapable of producing offspring despite being sexually active. Because female mosquitoes only mate once during their lifetimes, a single mating with a sterile male can ensure that she will never breed" This leads to an increasing reduction in the population over time, in contrast to insecticides, which kill a certain fraction of the insect population" (BioMed).

Considerable "research and development on the suppression of mosquitoes with the sterile insect technique (SIT) was conducted from the mid-1950s to the mid-1970s"; however, "nearly all of the scientists who pioneered this approach have retired and several of the greatest have died." The resurgence of this idea is due in part to "new technologies" that are "available to support area-wide integrated pest management (AW-IPM) programmes" (Klassen).

If implemented in Africa, the sterile insect technique when combined with other measures could effectively eliminate the malaria-carrying mosquito population in Africa.

For an overview of the history of malaria and the SIT project, please read the study's introduction in the malaria journal: http://www.malariajournal.com/content/8/S2/I1

Sources:
BioMed Central. "Are Sterile Mosquitoes the Answer to Malaria Elimination?." ScienceDaily 17 November 2009. 18 November 2009 .
Klassen, Wauldemar. "Introduction: development of the sterile insect technique for African malaria vectors". Homestead, Florida. 16 November 2009.

New Moon -- The Twilight Saga

2009-11-17T22:36:00.007-05:00

Hold on to your teeth, Ana Revenant is writing a blog article about New Moon. You should ask yourself: why? Then, you should realize that malaria must be involved.

Congratulations, you've cracked the code. I will do almost anything to raise awareness of the threat of malaria...even if that means promoting glittering vampires.

Malaria No More, a non-profit organization that provides malaria awareness education and relief, "is offering Twilight fans the chance to win two tickets to the early and exclusive New York City Press Screening of 'The Twilight Saga: New Moon' Wednesday, November 18th at Lincoln Center".

Excerpts from Malaria No More about their contest: [CONTEST CLOSED]

On Facebook, the contest is to recruit the most friends to join the Malaria No More Twilight Causes Page. The "Top Recruiter" will be notified via a private Facebook message. Malaria No More Causes Page: http://apps.facebook.com/causes/399734

On Twitter, the contest is to create a catchy tweet that relates a malarial mosquito to a vampire, and includes the hashtag #MNMBLOOD. The person that tweets the most interesting relationship in 140 characters and with the hashtag will be notified with a direct message. Twitter: http://twitter.com/

More information can be found on the Malaria No More blog page: http://malarianomore.org/blog/?p=2099

Enjoy the contest, and be warned: I may be lurking outside the movie theater waiting to dine on the well-marinated dinner entrees that walk into my arms. Ciao!

Malaria in Vanuatu

2009-11-16T10:05:00.005-05:00

"Vanuatu, an archipelago of over 80 islands in the South Pacific, ranks behind only the Solomon Islands for having the highest rate of malaria infections. Malaria in Vanuatu has been getting steadily worse since the 1980s, which is why UCSF scientists are among the medical professionals working hard to control malaria in this region" (UCSF).

Malaria parasites are found in all regions of Vanuatu, and "[t]ransmission occurs from December to May. Either mefloquine (Lariam), atovaquone/proquanil (Malarone), or doxycycline may be given. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure." Malarone is a "combination pill taken once daily with food," the side-effects of which are "typically mild". Doxycycline "is effective," against malaria in Vanuatu "but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics" (MD Health). It is important to know that "Chloroquine is NOT an effective antimalarial drug in Vanuatu and should not be taken to prevent malaria in this region" (CDC). Malaria resistance to Chloroquine is becoming increasingly throughout the world as the parasite adapts.

"UCSF researchers, with funding from the Bill and Melinda Gates Foundation", "are conducting a large-scale household-level survey of malaria treatment and prevention practices in Vanuatu. Over 900 households on four islands (out of a total of more than 80, although only a few are populated) have participated in the study. Researchers also collected blood samples from all members of the households selected for the survey, which will permit them to link survey responses on prevention and treatment practices to biological markers" (UCSF).

For more information on the study, please visit UCSF web page.

Sources:
CDC. Malaria in Vanuatu. http://wwwnc.cdc.gov/travel/destinations/Vanuatu.aspx

MD Travel Health. 'Vanautu'. http://www.mdtravelhealth.com/destinations/oceania/vanuatu.php

UCSF. Malaria Prevention. http://medschool.ucsf.edu/news/features/public_service/20060619_Malaria.aspx

Vaccine trials

2009-11-03T19:55:00.002-05:00

Raise your hand if you took note of the press release regarding the malaria vaccine to jump at the chance to announce it before me. I see you there, sitting alone, sheepishly raising your hand. Actually, I'm quite proud of you. You're paying attention, spreading the word, and enlightening the world. Raise your hand higher, be proud! Oh wait. You in the public library: Put your hand down. People can see you.

So why is Ana so late to the party? No one told me the media gods were releasing the news today. I'm not psychic, you know. Also, I was preoccupied with public transit issues. Don't ask...

Of the emails and messages I received from avid followers, these are my favorites:
Can this really be true? Yaa!
Vampire fans -- this could be a breakthough.
Look [link] Why haven't you written yet? Did you get staked?

Calm yourselves, people. I'm not hindered by the strike of a little stake. The picketing version may be a different story, however.

Now that I'm back online, let me abbreviate the news:

"A pivotal efficacy trial of RTS,S, the world's most clinically advanced malaria vaccine candidate, is now underway in seven African countries: Burkina Faso, Gabon, Ghana, Kenya, Malawi, Mozambique and Tanzania" (PATH). This vaccine is the first to be designed specifically for malaria in Africa. Trials are being conducted in seven countries and different regions "across Sub-Saharan Africa" in order "to evaluate the vaccine candidate's efficacy in a variety of settings, with diverse patterns of malaria transmission. For example, some trial sites are located in areas where there is a year-round threat of malaria, while others experience only seasonal transmission". "The vaccine profile is intended primarily for infants, as they and children under the age of five are the most vulnerable to malaria" (PATH).

Previous research "studies showed that RTS,S reduced clinical episodes of malaria by 53 percent over an eight-month follow-up period" (PATH). Phase III trials are being conducted in what is now "the largest trial ever conducted in Africa of a vaccine specifically designed for use with African children."

Sources:
PATH Malaria Vaccine Initiative (2009, November 3). World's Largest Malaria Vaccine Trial Now Underway In Seven African Countries. ScienceDaily. Retrieved November 3, 2009, from http://www.sciencedaily.com¬ /releases/2009/11/091103102248.htm

Antimalarial side effects

2009-10-28T20:57:00.001-05:00

In early October, a study comparing the side effects of commonly prescribed malaria medication was conducted by a team led by Dr. Frederique Jacquerioz at Tulane University. "The review looked at eight clinical trials" of commonly prescribed anti-malarials. Both "atovaquone-proguanil -- sold under the brand-name Malarone -- and doxycycline appear to have fewer side effects" than the other drugs tested. "With these two drugs, there is lower risk of nausea, stomach pain and other gastrointestinal side effects, and also neurological and psychiatric side effects, such as dizziness, sleep disturbances, anxiety and depression."

No drugs produced side effects that were considered life-threatening or required hospitalization; however, the investigators did discover a disturbing link between mefloquine and patient death. They uncovered "published case reports linking mefloquine to 22 deaths, including five suicides." It is important to note that "no other anti-malaria drugs have been linked to deaths when taken at prescribed doses".

Mefloquine is still an effective anti-malarial and may be safely prescribed to patients who have previously taken it without adverse effects. Doctors believe that risk of death is higher for patients who fail to take mefloquine when they should than the risk of serious side effects.

"[S]evere reactions to mefloquine are rare, noted Dr. Andrea Boggild of Toronto General Hospital in Canada, who was not involved in the study. In a written statement, Boggild said that severe neurological and psychiatric symptoms develop in just one out of every 6,000 to 10,000 people who take the drug."

In regard to antimalarial side effects, the Jacquerioz says this: "The main message is that you have to take some malaria chemoprophylaxis (preventive treatment) if you go to an endemic area". Malaria kills approximately one-million people each year, and an estimated ten-thousand to thirty-thousand travelers develop malaria annually.

"Boggild advised people who are planning a trip to a malaria-endemic area to talk with a healthcare provider who specializes in travel medicine about how to best protect themselves."

Source:
Reuters Health. " Two anti-malaria drugs have fewer side effects". Wednesday, October 7, 2009.

The Democratic Republic of the Congo

2009-10-24T10:02:00.005-04:00

"The people of the Democratic Republic of the Congo desperately need help. People are dying every day from diseases we can prevent and treat" (WHO, Donor). Malaria is one of the biggest killers in the Democratic Republic of the Congo (formerly known as Zaire). "Health experts estimate that each child under five years of age in DRC has 6 to 10 attacks of malaria per year. This is equivalent to as many as 100 million episodes, or even more, annually. Approximately 180,000 Congolese children under five die from the disease every year, and many others are orphaned when malaria weakens and kills their parents" (Gilliam).

"In less than five years, more than 3 million people have died - most from preventable and treatable diseases. The public health infrastructure is virtually broken down. The risk of epidemics remains high. Without international support to restore basic health care services, the humanitarian crisis in the Democratic Republic of the Congo will only continue to worsen" (WHO, Donor). The country's health system "is severely weakened with insufficient capacity to meet the needs of the population...In many areas, the health system functions as if it were private and patients cannot afford to seek assistance. Numerous private pharmacies provide drugs of dubious quality." Furthermore, most "health workers have not received salaries...for decades. Doctors have left the periphery and gone to the cities or to international agencies for employment...The health worker education system does not function anymore, and there are concerns about the staff qualifications" (WHO, Country).

Current estimates report that "6 out of 10 children do not reach their 5th birthday" (WHO, Donor). "Malaria (P. Falciparum) is endemic" in the country "and is accountable for 45% of childhood mortality. Children under five, of whom only an estimated 0.7% sleep under an insecticide-treated net, suffer from six to ten malaria-related fever episodes each year" (WHO, Country).

"With the rainy season just days away, UNICEF, along with partners including UNITAID and the World Food Program, is mobilizing the distribution of some 5.5 million mosquito bed nets in DRC. Each has been treated with insecticide and can help reduce the risk of contracting malaria for those who sleep under them at night" (Gilliam).

The people of the Democratic Republic of the Congo need your help. While Non-governmental organizations and charities are donating and distributing mosquito nets to the country, the need is still great. Visit one of the sites below for information on how you can help send mosquito nets to people in need in the Democratic Republic of the Congo. Also, visit our Help Us page for information on how you can help Infectious Bite raise malaria awareness.

Links:
Malaria No More
Netting Nations

Sources:
Gilliam, Eva. UNICEF. "Malaria campaign underway in Democratic Republic of Congo" 5 October 2009.

WHO. Country Profile: DRC. http://www.who.int/hac/crises/cod/drc_profile_dec08.pdf
WHO. Photo Gallery. [Photo]
WHO. Donor Profile: DRC. http://www.who.int/hac/donorinfo/campaigns/cod/en/

Genetic Diversity

2009-10-21T23:07:00.003-04:00

"Scientists and health officials worldwide have made eradication of" malaria "a priority, with an effective and broadly protective vaccine a critical step toward that goal. Malaria -- a parasite spread to humans through mosquito bites -- is prevented by avoiding mosquito bites using bed nets or by killing mosquitoes with insecticides. The parasite is treatable using medications, although drug resistance is a relatively common problem. According to the World Health Organization, a child dies of malaria every 30 seconds" (University). Currently, "no approved vaccine for malaria" exists, but "various experimental vaccines are in development" (University). As of now, "vaccines directed against the blood stages of Plasmodium falciparum malaria [a deadly strain] are intended to prevent the parasite from invading and replicating within host cells. No blood-stage malaria vaccine has shown clinical efficacy in humans" (Takala).

"Researchers at the University of Maryland School of Medicine Center for Vaccine Development (CVD) have charted the extreme genetic differences that occur over time in the most dangerous malaria parasite in the world" (University). They "examined the extent and within-host dynamics of genetic diversity in the blood-stage malaria vaccine" and concluded that this "extreme diversity may pose a serious obstacle" to the creation of an effective vaccine.

"The CVD study suggests that developing a broadly protective vaccine for malaria may be challenging because the parasite's genetic makeup is so variable, constantly changing" (University).

Sources:
Takala, Shannon L. et al. "Extreme Polymorphism in a Vaccine Antigen and Risk of Clinical Malaria: Implications for Vaccine Development." Sci Transl Med 14 October 2009:
Vol. 1, Issue 2, p. 2ra5.

University of Maryland Medical Center. "Extreme Genetic Variability In Malaria Parasite Found." ScienceDaily 15 October 2009. 21 October 2009 .

Malaria & Climate Change

2009-10-15T13:10:00.007-04:00

Update on climate change as it relates to malaria (4 March 2010)

Every year approximately one million people die from malaria, and most of those are children. 350-500 million people are infected annually. This blood parasite is spread through the bite of infested mosquitoes and most frequently occurs within tropical regions. However, "malaria is an extremely climate-sensitive" disease that cannot be contained to the tropics (Patz). Medical researchers warn about the global threat of malaria in the future due primarily to climate change.

Climate change threatens to expand the mosquito's habitats, thereby spreading the disease. A joint study by the State University of New York and the Kenya Medical Research Institute showed that changes "in temperature can affect the development and survival of malaria parasites and the mosquitoes that carry them...Rainfall also influences the availability of mosquito habitats and the size of mosquito populations, the research found" (Barclay). A study conducted by Brown University researchers revealed that "an epidemic in Ethiopia was attributed to higher temperatures, rainfall and relative humidity than in previous years" (Brown).

A research team at University of Michigan (lead by M Pascual) has "documented a warming trend in the East African highlands from 1950 to 2002, concomitant with increases in malaria incidence. Moreover, their findings confirm the importance of the well recognized nonlinear and threshold responses of malaria (a biological system) to the effect of regional temperature change...For example, showing that the biological response of mosquito populations to warming can be more than an order of magnitude larger than the measured change in temperature represents a stunning finding, critical in advancing risk assessment of climate change impacts" (Patz).

[UNEP projected malaria distribution]

Outside of Africa, malaria is moving to higher altitudes and colder regions within endemic areas. "Malaria cases have been reported on the Bolivian high plateau," (Pabon). These individuals contracted the disease locally, meaning that malaria-carrying mosquitoes are now present in a region where they were previously unknown.

The US and UK are also under threat by malaria. Outbreaks of malaria within the US are not unknown, and may continue to increase as climates change. Florida and Louisiana are particularly susceptible to the disease. Across the pond, the UK reported 1370 cases of malaria in 2008. Six deaths were officially blamed on malaria (HPA). "A high likelihood of a major heat wave" may lead "to as many as 10,000 deaths, hitting the UK by 2012" warns the government (Prince). In coming years "the UK is to be hit by regular malaria outbreaks, fatal heat waves and contaminated drinking water within five years because of global warming, the Government has warned the NHS [National Health Service]" (Prince).

"The best climate conditions for malaria are a long rainy season that is warm and wet, followed by a dry season that is not too hot, followed by a hot and wet short rainy season," (Barclay). Pure global warming is not the primary culprit, instead a general shift in climate across regions is feared. Malaria is a devastating disease that infiltrates all areas of life. Epidemics destroy the health, economy, and cultural fabric of regions where malaria is prevalent.

We can make adjustments in our lives to prevent climate change; however, we also need to attack malaria to prevent its spread. Help Infectious Bite stop malaria in its tracks by supporting our cause or by donating to one of the many reputable agencies that provide mosquito nets and medicine to people threatened by malaria. Together we can Bite Malaria Back.

Sources:
Barclay, Eliza. " Climate Change Fueling Malaria in Kenya, Experts Say..." National Geographic. 9 January 2008.

Brown University. "Climate Change and Malaria". http://www.brown.edu/Research/EnvStudies_Theses/full9900/creid/climate_change_and_malaria.htm

Pabon, Cristina. Malaria spreading on Bolivian High Plains. SciDevNet.

Patz, Jonathan A. Sarah H Olson. "Malaria risk and temperature…" PNAS.

Prince, Rosa. "Malaria Warning as UK becomes warmer." Telegraph.co.uk. 12 Feb 2008.

UNEP: Map (http://maps.grida.no/go/graphic/climate_change_and_malaria_scenario_for_2050)

Hispaniola

2009-10-12T19:09:00.003-04:00

The island of Hispaniola is the home to the countries of Haiti and the Dominican Republic. It is also one of the few remaining regions in the Caribbean with endemic malaria.

"In September 2008, The Carter Center, in partnership with the Dominican Republic and Haiti, launched a historic one-year initiative to help the two countries and their other partners accelerate the elimination of two devastating mosquito-borne infections--malaria and lymphatic filariasis--from Hispaniola" (Carter). "Lymphatic Filariasis, known as Elephantiasis, puts at risk more than a billion people in more than 80 countries. Over 120 million have already been affected by it, over 40 million of them are seriously incapacitated and disfigured by the disease." Like malaria, lymphatic filariasis is caused by a blood parasite that is "transmitted by mosquitoes" (WHO).

"The leaders of Haiti and the Dominican Republic agreed Thursday to cooperate in a campaign aimed at eradicating the last vestiges of malaria from the islands of the Caribbean by 2020. What remains uncertain is how to fund the roughly $250 million effort, which also aims to eliminate lymphatic filariasis, on the two-nation island of Hispaniola" (Bluestein). Although the cost of eradication is high, it is diminutive when compared with the long-term economic damage that is caused by these parasites. "Malaria and lymphatic filariasis are costly economic burdens, as both diseases are caused by--and create--additional poverty. An outbreak of malaria on the island in 2004 cost the Dominican Republic an estimated US $200 million in lost revenue from tourism. Since then, two transient outbreaks of malaria in the Bahamas and another in Jamaica have been imported from Hispaniola, which also is the source of several cases of malaria imported to the U.S. each year" (Carter).

Sources:
Image: Filariasis parasite. Wikimedia Commons.
Bluestein, Greg. "Hispaniola leaders aim to eradicate malaria". Associated Press. 10 October 2009.
Carter Center, The. "The Hispaniola Initiative." http://www.cartercenter.org/health/hispaniola-initiative/index.html
WHO: World Health Organization. Lymphatic Filariasis

Poetry

2009-10-08T17:12:00.003-04:00

"MALARIA" [trans. by Laurence Hope]

He lurks among the reeds, beside the marsh,
Red oleanders twisted in His hair,
His eyes are haggard and His lips are harsh,
Upon His breast the bones show gaunt and bare.

The green and stagnant waters lick his feet,
And from their filmy, iridescent scum
Clouds of mosquitoes, gauzy in the heat,
Rise with His gifts: Death and Delirium.

His messengers: they bear the deadly taint
On spangled wings aloft and far away,
Making thin music, strident and yet faint,
From golden eve to silver break of day.

The baffled sleeper hears th' incessant whine
Through his tormented dreams, and finds no rest.
The thirsty insects use his blood for wine,
Probe his blue veins and pasture on his breast.

While far away He in the marshes lies,
Staining the stagnant water with His breath,
An endless hunger burning in His eyes,
A famine unassuaged, whose food is Death.

He hides among the ghostly mists that float
Over the water, weird and white and chill,
And peasants, passing in their laden boat,
Shiver and feel a sense of coming ill.

A thousand burn and die; He takes no heed,
Their bones, unburied, strewn upon the plain,
Only increase the frenzy of His greed
To add more victims to th' already slain.

He loves the haggard frame, the shattered mind,
Gloats with delight upon the glazing eye,
Yet, in one thing His cruelty is kind,
He sends them lovely dreams before they die;

Dreams that bestow on them their heart's desire,
Visions that find them mad, and leave them blest,
To sink, forgetful of the fever's fire,
Softly, as in a lover's arms, to rest.

"Malaria". India's Love Lyrics. Trans. Laurence Hope. New York: John Lane Co., 1906.

Fungus reduces malaria transmission

2009-10-07T18:25:00.000-04:00

"Biopesticides containing a fungus that is pathogenic to mosquitoes may be an effective means of reducing malaria transmission, particularly if used in combination with insecticide-treated bednets" (Public). Mosquito adaptation and resistance to insecticides is a major hindrance to malaria eradication. "In developing strategies to control malaria...there is increased interest in biological methods that do not cause instant" mosquito or parasite death. Instead, scientists are searching for preventative measures, which "have sublethal and lethal effects at different ages and stages in the mosquito life cycle", with the hope that these more mild approaches will be more effective in the long run than the aggressive techniques used in the past. (Hancock).

"[A]ccording to a modelling study conducted by Dr. Penelope Hancock from Imperial College London," incorporating fungal biopesticides "may substantially reduce malaria transmission rates and help manage insecticide resistance...Efficient combinations of interventions may allow each to be used at lower levels, and slow the development of resistance in the mosquito population" (Public).

Sources:
Hancock, Penelope A. "Combining Fungal Biopesticides and Insecticide-Treated Bednets to Enhance Malaria Control".

Public Library of Science. "Control Of Mosquito Vectors Of Malaria May Be Enhanced By A New Method Of Biocontrol." ScienceDaily 1 October 2009. 7 October 2009 .

Popcorn parasite

2009-10-04T19:33:00.002-04:00

Who would have thought that infecting "mosquitoes with a bacterial parasite could help prevent the spread" of blood parasites like malaria and lymphatic filariasis? If you guessed that it might, then you are either clever or very well-informed. For the rest of us, it is an exciting idea that may aid in "the control of...mosquito-borne parasites" (Wellcome).

Researchers have infected mosquitoes with a strain of Wolbachia, which is a bacterial parasite that infects insects and other arthropod species (Werren). The strain known as wMelPop, and nicknamed 'popcorn', can halve the lifespan of infected mosquitoes. "Mosquito-borne parasites such as the filarial nematode or the malaria parasite require an incubation period between ingestion and transmission, so only older mosquitoes" are "infective. Skewing the mosquito population towards younger individuals reduces the number of infectious insects." In the case of lymphatic filariasis, a parasitic worm that is transmitted by mosquitoes, wMelPop has also been shown to encourage "the mosquito's immune system to attack" the parasite that it hosts (Wellcome).

The 'Popcorn' strain may reduce the number of mosquitoes and the likelihood that they will transmit a parasite that is deadly to humans. Researchers are "currently looking at whether infecting other species of mosquito, such as Anopheles gambiae - the mosquito responsible for the majority of malaria infections - with wMelPop will have a similar effect and help inhibit malaria transmission as well as filariasis transmission."

Sources:

Kambris Z et al. Immune activation by life-shortening Wolbachia and reduced filarial competence in mosquitoes. Science 2009.

Wellcome Trust (2009, October 2). Parasite Bacteria May Help Fight Spread Of Mosquito-borne Diseases. ScienceDaily. Retrieved October 4, 2009, from http://www.sciencedaily.com /releases/2009/10/091001163601.htm

Werren, J.H.; Guo, L; Windsor, D. W. (1995). "Distribution of Wolbachia in neotropical arthropods". Proc. R. Soc. London Ser. B 262: 147–204.

African Leaders Malaria Alliance

2009-09-29T19:12:00.004-04:00

"Malaria is one of the biggest killers of African children." Recently, "African leaders have begun an ambitious program to eliminate nearly all malaria deaths in Africa over the next six years." Initiated by Tanzanian President Jakaya Kikwete, the African Leaders Malaria Alliance was established "to streamline the procurement and distribution of control and treatment methods while keeping the disease high on the international development agenda" (Scott). "The international community has already donated more than $3 billion to the project, the BBC reports, adding, "The money will pay for the distribution of 240 million insecticide-treated bed nets throughout sub-Saharan Africa by the end of next year" (Nyaria).

"Africa is the continent most affected by malaria, accounting for 86 percent of all cases and 91 percent of all malaria deaths worldwide" (Henry). The statistics are sobering. "Nearly twenty percent of African women who die in childbirth" suffer "from malaria. It accounts for one-quarter of all deaths of children under five" (Scott). Every year, nearly a million people die.

The goal of the alliance "is to provide universal access to malaria control methods to all at-risk Africans by the end of next year in hopes of eliminating all preventable malaria deaths by 2015" (Scott). Ray Chambers, the Secretary General's Special Envoy for Malaria, says, "This is a massive undertaking unlike anything that has ever been done before."

Sources:
Associated Press. (via VOAnews.com) [Photo]

Henry J. Kaiser Family Foundation. "African Leaders Malaria Alliance Launched At U.N. General Assembly." Medical News Today. 29 Sept 2009.

Nyaria, Sandra. "African Leaders in Alliance to End Malaria Deaths on Continent By 2015." VOAnews.com. 23 Sept 2009.

Stearns, Scott. "African Leaders Fight Malaria." VOAnews.com. http://www.voanews.com/english/2009-09-22-voa52.cfm?rss=topstories. 29 Sept 2009.

Infectious Bite needs your help

2009-09-20T23:39:00.012-04:00

I'm pleased to tell you that recently Infectious Bite has received many emails from individuals who wish to help spread awareness about malaria. To those individuals: I sincerely thank you.
Infectious Bite is an awareness and education organization. You can show your support and deliver pertinent information about malaria to the public by adding one of these notes to your profile page or website. [Single click to view image. Right click, & save.]


A single dose of malaria medication costs approximately 13 cents. Unfortunately, infected individuals can often not afford or find the necessary medication. $10 buys and delivers a bed net (through MalariaNoMore, NothingButNets, or the CDC Foundation), which can protect two children nightly, and prevent them from contracting malaria.		There are 350-500 Million cases of malaria annually. Each year, there are about 1 Million deaths. Most of the dead are children and pregnant women.

Show your support and encourage action with this simple note.		It is estimated that Africa's annual GDP would increase by $100 Billion if malaria were eradicated. Malaria is not just a health problem, it is also an economic drain.


Malaria kills 350-500 million people each year. Per day, there are 2700 malaria-related deaths. This is a global health concern of massive proportions.

Malaria is a disease that infects all areas of life. The economies of malaria-laden countries suffers from a reduced or disabled workforce and high mortality rate. It is estimated that Africa's GDP would be $100 Billion dollars greater (annually) if malaria were eradicated.

You can also spread awareness about the devastation of malaria by purchasing and wearing an Infectious Bite t-shirt. Profits support our educational events and go to malaria relief.

We appreciate all offers for help. With your help we can bite malaria back.

Tigecycline treats malaria

2009-09-17T10:44:00.003-04:00

"Increasing resistance of Plasmodium falciparum to existing drugs has resulted in the search for new antimalarial therapies" (American). "A new study suggests that tigecycline, the first member of a new class of antibiotics, shows significant antimalarial activity on its own and may also be effective against multi drug-resistant malaria when administered in combination with traditional antimalarial drugs" (ScienceDaily).

"Tigecycline is a novel glycylcycline antibiotic with a broad antibacterial spectrum" (Starzengruber). This drug was "specifically designed to overcome" drug-resistant disease (American). Research showed that it was "up to 6 times more active against P. falciparum than doxycycline," a medication that is commonly used to treat malaria (ScienceDaily). "Tigecycline shows no activity correlation with traditional antimalarials and has substantial antimalarial activity on its own" (Starzengruber). Researchers hope that because of "its clinical efficacy", Tigecycline may be used "in combination with faster-acting antimalarials in the...treatment of multidrug-resistant P. falciparum malaria in seriously ill patients" (American).

There are some side-effects to Tigecycline treatment, and the manufacturers warn that it "may cause fetal harm when administered to a pregnant woman" (Wyeth). Pregnant women are particularly susceptible to malaria. Every year, approximately one million people die from malaria, and most of them are pregnant women and children. Nevertheless, the reduction in number of malaria cases in a region will improve the general health and economy of that are and help reduce the likelihood that pregnant women will contract malaria.

Sources:
American Society for Microbiology. "New Antibiotic Shows Promise in Fighting Malaria." 17 Sept 2009.

ScienceDaily. "New Antibiotic Shows Promise In Fighting Malaria." 11 September 2009. 17 September 2009 .

Starzengruber, P. et al. "Antimalarial Activity of Tigecycline, a Novel Glycylcycline Antibiotic." 6 March 2009.

Wyeth.com. Tygacil. http://www.wyeth.com/hcp/tygacil. [Photo]

Monkey malaria

2009-09-13T22:07:00.005-04:00

"Researchers in Malaysia have identified...an emerging new form of malaria infection" that is a "potentially deadly" strain of the disease (ScienceDaily). "Malaria kills more than a million people each year. It is caused by malaria parasites, which are injected into the bloodstream by infected mosquitoes" (Daneshvar).

"Recently, researchers at the University Malaysia Sarawak...showed that P. knowlesi, a malaria parasite previously thought to mainly infect only monkeys - in particular long-tailed and pig-tailed macaques found in the rainforests of Southeast Asia - was widespread amongst humans in Malaysia." After several similar reports, P. knowlesi has been deemed "the fifth cause of malaria in humans" (ScienceDaily).

P. knowlesi malaria is particularly dangerous because it "can easily be confused with P. malariae", a more benign form of malaria (ScienceDaily). Under the microscope, the two strains appear nearly identical, but the strains are very different in severity and deadliness. "One of the most significant findings of the study is that Plasmodium knowlesi was found to have the ability to reproduce every 24 hours in the blood -- meaning infection was potentially deadly. This, according to the researchers, meant early diagnosis and treatment were crucial" (Kounteya).

A universally low platelet count is another curious characteristic of this strain of parasite. "In other human forms of malaria, this would only be expected in less than eight out of ten cases." But, "all of the P. knowlesi patients - including those with uncomplicated malaria - had a low blood platelet count...The researchers believe the low blood platelet count could be used as a potential feature for diagnosis of P. knowlesi infections." (ScienceDaily).

"Recently, there have been cases of European travellers to Malaysia and an American traveller to the Philippines being admitted into hospital with knowlesi malaria following their return home" (ScienceDaily). This deadly strain of malaria may potentially spread across the globe and infect millions if it is not adequately treated and controlled.

Sources:
Daneshvar C, et al. Clinical and laboratory features of human Plasmodium knowlesi infections. Clin Infect Dis. 2009;49(6):852-60.

Kounteya Sinha. The Times of India. "Monkey malaria spreads to humans in South-east Asia". 11 September 2009.

ScienceDaily. In Humans. Retrieved September 13, 2009, from http://www.sciencedaily.com /releases/2009/09/090909103004.htm

Schweinsaffe im Tierpark Berlin (photo)

Herbal medicine

2009-09-08T15:24:00.006-04:00

"An ancient Chinese folk medicine that's effective against malaria also might be a potent cancer-fighting candidate, scientists at the University of Washington say" (Hill). "A derivative of the sweet wormwood plant used since ancient times to fight malaria and shown to precisely target and kill cancer cells may someday aid in stopping breast cancer before it gets a toehold" (Harril). "Artemisia annua...has shown favorable...results" against "breast cancer and prostate cancer" (Artemisinin).

"The substance, artemisinin, appeared to prevent the onset of breast cancer in rats that had been given a cancer-causing agent." Artemisinin is "selectively toxic to cancer cells" (Harril). "The compound appears to be extremely" harmful "to cancer cells but had little impact on normal cells," according to the researchers (Hill).

"The properties that make artemisinin an effective antimalarial agent also appear responsible for its anti-cancer clout. When artemisinin comes into contact with iron, a chemical reaction ensues that spawns free radicals -- highly reactive chemicals that, when formed inside a cell, attack the cell membrane and other structures, killing the cell...The malaria parasite can't eliminate iron in the blood cells it eats, and stores it. Artemisinin makes that stored iron toxic to the parasite...The same appears to be true for cancer. Because they multiply so rapidly, most cancer cells have a high rate of iron uptake. Their surfaces have large numbers of receptors, which transport iron into the cells. That appears to allow the artemisinin to selectively target and kill the cancer cells, based on their higher iron content" (Harril). "In addition," artemisinin has already "been shown to be safe" in humans, as is evident in malaria patients who have taken the drug (Hill). Artemisnin may provide an alternative for harsh chemotherapy in some cancer cases.

Sources:
“Artemisinin Herbal Extract Cures Malaria, Breast Cancer and Leukemia”. Associated Content. 29 March 2009.

Harril, Rob. “Malaria drug may help prevent breast cancer, study shows”. University Week. Jan. 12, 2006

Hill, Richard. The Oregonian, 28 Nov 2001 p C12.

Koresby Online. Artemisinin Annua. (Photo)

Malaria and antibiotics

2009-09-04T11:56:00.003-04:00

Malaria is a parasite that is transmitted by mosquitoes and infects a million people a year. Since this disease is not caused by a bacterium, how is it that antibiotics affect malaria and improve the health of sickened individuals?

From 1920 to 1950, antibiotics were a widely used treatment for malaria, although medical practitioners were not entirely sure why this treatment was so effective (Butcher). In the early 1980s, it was "discovered that antibiotics ... are active as antimalarial agents" (Oronsky). More recently, azithromycin [also called Zithromax] has been used to treat malaria in Ethiopia after it was shown "to have efficacy in the prevention and treatment of malaria due to both Plasmodium falciparum and Plasmodium vivax," (Travis).

After research, scientists have hypothesized that antibiotics treat malaria because they attack the plasmodia (a protozoa) within the parasites; therefore the antibiotics diminish the malaria" (Flam). Furthermore, antibiotics alleviate the immune system of other infections that may coexist with malaria.

"The treatment may also have unintended consequences...including the inducement of antibiotic resistance" (Travis). However, the situation is further complicated by the development of drug-resistant bacteria in malaria-infested areas that have had no exposure to antibiotics.

As mysterious as the seemingly unfounded effectiveness of antibiotics on malaria in the 20th century, the unexplained drug-resistant bacteria in "remote rainforest communities in Guyana" confounded scientists (Juncosa). New studies revealed "that overuse of a drug used to prevent and treat malaria may be contributing to growing antibiotic resistance...Drug-resistant bacteria are known to arise from the overuse of antibiotics, which is why researchers were surprised to discover that they can develop in areas that do not have access to" that particular antibiotic [ciprofloxacin]. Michael Silverman, "an infectious disease specialist at Lakeridge Health Network in Ontario" says that antibiotic-resistant E. coli were more widespread in these remote Guyanese villages than in U.S. hospitals "where every second person is on antibiotics." Silverman's study showed that the patients infected with drug-resistant E.coli had been "given the drug chloroquine to prevent and treat malaria" (Juncosa).

According to Silverman, "It is very possible that the antimalarial drugs may be inducing a large amount of the antibiotic resistance that occurs in the tropics." Unfortunately, "plasmodia, the causative organisms of malaria, have developed resistance to antibiotics" as well and "at the same time, the mosquitoes that carry plasmodia have become resistant to the insecticides that were once used to control them. Consequently, although malaria had been almost entirely eliminated, it is now again rampant in Africa, the Middle East, Southeast Asia, and parts of Latin America" (MSN).

The increasing number of drug-resistant strains of malaria parasite, plasmodia, and other bacteria is another reason why an effective malaria vaccine is so important. We cannot continue treating malaria in the ways that we have in the past, for very soon, these old methods will be rendered ineffective.

Sources:
Butcher, Geoff. “Million Murdering Death.” History Today April 1998: 24-28.

Flam, Fray. “Scientists Find Weak Spot in Defense of Tenacious Malaria Parasite.” Tribune News Service November 1997: 26-28.

Juncosa, Barbara. "Antibiotic Resistance: Blame it on Lifesaving Malaria Drug?" Scientific American 21 July 2008.

MSN Encarta."Antibiotics"

Oronsky, Arnold L. Treatment of malaria with antibiotics. "United States Patent 4496549" 29 Jan 1985.

Science News. "Distribution Of Antibiotic For Eye Disease Linked To Low Death Risk Among Ethiopian Children." 1 Sept 2009.

Travis C. Porco; Teshome Gebre; Berhan Ayele; Jenafir House; Jeremy Keenan; Zhaoxia Zhou; Kevin Cyrus Hong; Nicole Stoller; Kathryn J. Ray; Paul Emerson; Bruce D. Gaynor; Thomas M. Lietman. Effect of Mass Distribution of Azithromycin for Trachoma Control on Overall Mortality in Ethiopian Children: A Randomized Trial. JAMA, 2009; 302 (9): 962-968

Malaria Outbreak in Palm Beach, Florida

2009-08-30T23:26:00.006-04:00

Americans living within the borders of the United States feel removed from the problem of malaria. Every so often it's mentioned in passing: Ashton Kutcher buys mosquito nets for children in Africa. The Gates Foundation makes a donation. But, this deadly parasite can infiltrate loosely-screened borders of any country. Malaria only needs to hijack the immune system of a single individual in order to start an epidemic.

In 2003, Palm Beach saw an outbreak of malaria. Victims ranged in wealth and status, profession and hobbies. All but one contracted malaria without having set foot outside the United States. "The hospital staff, inexperienced in working with the disease, failed to correctly identify the infections" (Packard 6). Health-care providers did not "consider malaria as a possible cause of fever among patients who have not traveled," but who experience "alternating fevers, rigors, and sweats with no obvious cause" (CDC). Calling it pneumonia and prescribing antibiotics, the hospitals sent the patients home, where they continued "to infect local mosquitoes" (Packard 6).

Anopheles mosquitoes (the ones that transmit malaria) swarm within the United States. "Palm Beach County was riddled with drainage ditches and canals, which were prime habitats for" mosquitoes (Packard 6). Between 1992 and 2003, "11 outbreaks" including at least twenty cases of "locally acquired mosquito-transmitted malaria" were reported to the CDC (CDC).

It only takes one infected individual to start an outbreak. Patient zero [the first case] may not show outward signs of the disease. This carrier could be on a regiment of symptom-suppressing medications, be recently infected, or even be immune to malaria.

In the particular case of the Palm Beach outbreak, the CDC "concluded that a migrant worker or international traveler might have been involved" (Packard 6). That traveler was not identified. The Palm Beach outbreak "demonstrated the potential for reintroduction of malaria into the United States despite intense surveillance, vector-control activities [vector=agent], and local public efforts to educate clinicians and the community" (Packard 6). It is impossible to prevent malaria from penetrating the US borders when so much of the world suffers heavily from this disease.

Malaria is a global disease. It will only be controlled by a united global assault dedicated to eradication.

Sources:
CDC. "Local transmission...". MMWR Weekly. 26 Sept 2003.

Packard, Randall M. The Making of a Tropical Disease: A short history of malaria. John Hopkins: 2007.

Malaria in Tibet

2009-08-28T16:50:00.006-04:00

Rarely a soul considers the risk of malaria while gazing upon the snow-covered Himalayas. Why should one bother? Tibet's high-altitude and cold-weather eliminate malaria-transmitting mosquitoes in most regions. For this reason, many travel books and web sites declare that "there is no risk of malaria in Tibet" (NaTHNaC). Unfortunately, this is absolutely untrue.

"Malaria is endemic in Linzhi Prefecture in the Tibet Autonomous Region (TAR), but the vector [definition: agent] for malaria transmission" was not identified until recently. It is now believed that the mosquito, "Anopheles pseudowillmori[,] is the predominant malaria vector" in the region (Song). Preventative treatment "is recommended...for travel along the valley of the Zangbo river in the extreme southeast" of Tibet (MD). "Anti-malaria medication is recommended for low-lying subtropical areas", particularly "during the rainy season" (Dorje 49).

Tibet is home to the "Falciparum type of malaria," which is considered to be the most dangerous and most deadly strain of malaria. "Various combinations of drugs are being used such as Quinine, Tetracycline or Halofantrine. If falciparum type of malaria is definitely diagnosed, it is wise to get a good hospital as treatment can be complex and the illness very serious" (Dorje 58). Clearly, "protection against mosquitoes and drug prophylaxis against malaria are essential" when traveling to certain areas of Tibet, and all travelers should be aware of the risk of infection (51).

Sources:

Dorje, Gyurme. Tibet handbook: with Bhutan.

Galuzzi, Luca. Photo.

MD Travel Health. "Tibet". 28 August 2009.

NaTHNaC. "China (Tibet)." 28 August 2009.

Song, Wu. Et al. Malaria Journal 2009. "Anopheles pseudowillmori is the predominant malaria vector in Motuo County, Tibet Autonomous Region." 16 March 2009.

Genetically-engineered malaria vaccine

2009-08-25T23:42:00.004-04:00

Scientists have created a "weakened strain of the malaria parasite" that "will be used as a live vaccine against the disease." This type of vaccine "has proven successful in eradicating smallpox and controlling diseases such as flu and polio" (Walter). It has already been advantageous in animal studies, and it is hoped that it will prove successful when it enters human trials (slated for early next year).

Professor Alan Cowman, head of the Walter and Eliza Hall Institute's Infection and Immunity division, said that "in developing the vaccine the research team...deleted two key genes in the Plasmodium falciparum parasite - which causes the form of malaria most deadly to humans" (Walter). "The deletions did not affect the parasites throughout most of the life cycle," but "by removing the genes the malaria parasite is halted during its liver infection phase, preventing it from spreading to the blood stream where it can cause severe disease and death" (Cowman; Walter). The photo to the left shows the parasitic cells during the liver stage (WT is normal).

The fact that the deletion of the genes "did not result in any observable defect during blood-stage replication...indicated that gene deletions did not affect the sexual stages of the parasite" (Cowman). "Although two genes have been deleted the parasite is still alive and able to stimulate the body's protective immune system to recognize and destroy incoming mosquito-transmitted deadly parasites" (Walter).

"Similar vaccines" have "been tested in mice and offered 100 per cent protection against malaria infection." Cowman "said it was hoped the vaccine would produce similar results in humans" (Walter). Whenever working with an attenuated [definition: weakened] strain of a disease, mutation is always a concern. Some people fear that the parasite will mutate to a viable form, thereby infecting individuals through the vaccine. "Professor Cowman said it was unlikely the weakened parasites used in the vaccine would regain their potency as the genes had been deleted from the genome and could not be recreated by the parasite" (Walter).

The fact that two essential genes have been deleted "make it extremely unlikely that the attenuated parasite vaccine could restore its capacity to multiply and lead to disease." The scientists believe that their "genetically attenuated parasite approach provides a safe and reproducible way of developing a whole organism malaria vaccine," which has the unique ability of being nearly 100% effective (Walter).

Sources:
Cowman, Alan F. et al. "Preerythrocytic, live-attenuated Plasmodium falciparum vaccine candidates by design." 10 June 2009.

Walter and Eliza Hall Institute (2009, August 24). First Genetically-engineered Malaria Vaccine To Enter Human Trials. ScienceDaily.

The solution with a crystalline heart

2009-08-24T00:06:00.008-04:00

A team at McGill University (and RI-MUHC) in Montreal is scrambling to create a malaria vaccine. The researchers, lead by Dr. Martin Oliver, "may have blazed a trail towards the development of vaccine-like treatments to limit the severity of the devastating parasitic ailment" (Science).

The team's new discovery may lead to the development of a medication that stops malaria from creating the debilitating inflammation that is associated with malaria. "Inside the human body, the malaria parasite infects red blood cells where it survives and reproduces by feeding on the cells' contents. Eventually the cells burst, releasing the parasites and also a waste byproduct of their reproductive process: hemozoin" (Tiemi). Hemozoin is the "chemically inert crystalline substance produced in the digestive food vacuole of blood-stage malaria parasites" (Parasitology).

Although chemically inert, it is still a foreign substance in the body. The Hemozoin is "one way by which the immune system is alerted to malarial infection." It "activates the immune system, resulting in the production of inflammation mediators and in the high fever." The researchers believe that hemozoin "may be the missing link that explains why malaria leads to devastating inflammation and fever...The researchers believe it will be possible to familiarize the immune system to small quantities of hemozoin and diminish the inflammatory response in the event of infection, according to a principle similar to that of vaccines" (Science). Dr. Olivier explains that "Now our picture of the process that goes from infection to fever is more or less complete."

However, a final solution is not yet apparent. "Malaria is too complex to be narrowed down to one single mechanism" (Tiemi). Although the relationship between hemozoin and inflammation is important, there are most like many other mechanisms at work.

Will a malaria vaccine ever be available? It is certainly possible, but more research and development is needed before we will know for sure.

Sources:

Parasitology Encyclopedia. Hemozoin.

Tiemi Shio M, Eisenbarth SC, Savaria M, Vinet AF, Bellemare M-J, et al. Malarial Hemozoin Activates the NLRP3 Inflammasome through Lyn and Syk Kinases. PLoS Pathogens, 2009; 5 (8): e1000559 DOI: 10.1371/journal.ppat.1000559

Hempelmann, Birefringent Plasmodium falciparum hemozoin. [Photo]

Science Daily. "Towards Malaria 'Vaccine': Discovery Opens The Door To Malaria-prevention Therapies." 23 Aug 2009.

World Mosquito Day

2009-08-20T00:46:00.005-04:00

The 20th of August is World Mosquito Day. What are you doing to stop malaria?

World Mosquito Day was introduced in "an effort to remind the public about the continuing threat of malaria and other diseases transmitted by mosquitoes" (Mirsky). "Each year, approximately 350 to 500 million people are infected with malaria, killing 1 to 3 million people, mostly young children in Sub-Saharan Africa. Only female Anopheles mosquitoes that had previously bitten a person infected malaria will transmit the disease. Currently there is no vaccine that can provide high level of protection, and malaria parasites have evolved to resist many antimalarial drugs" (NowPublic).

Unfortunately, "it's not a day to celebrate" instead, it's "an awareness day. Ronald Ross of the Liverpool School of Tropical Medicine originated World Mosquito Day in 1897. He's the guy who figured out that mosquitoes carried the malaria parasite. He got one of the first Nobel Prizes for it in 1902" (Mirsky). By the way, he was also knighted in 1911. "Sir Ronald Ross was a British physician born in Almora, India. He had the breakthrough discovery during the dissection of a specific species of mosquito, the Anopheles, previously fed on a malaria patient. Malaria parasite was found on the mosquito and on its salivary glands" (NowPublic).

"112 years later, the fight against malaria is still on" (NowPublic). On this World Mosquito Day, motivate yourself to mention malaria and it's global threat to your peers, acquaintances, or that woman who swats at mosquito while she's waiting for the bus. Together, we can Bite Malaria Back.

Sources:
Mirsky, Steve. "Bite Back on World Mosquito Day." Scientific American. 19 August 2009.
NowPublic. "World Mosquito Day on August 20: Fight against Malaria" 19 August 2009.
Photograph by Hugh Sturrock

Ethiopia's epic battle against the Waba and malaria

2009-08-18T23:20:00.007-04:00

Wäba: a mosquito that is carrying malaria (Amharic).

Does it strike you as strange that a language would have a specific term for a malaria-carrying mosquito? In a country that has seen 9 million cases of malaria per year, a distinction between malaria-infested mosquitoes and unaffected mosquitoes is necessary (UNICEF). Ethiopia is hit hard by malaria, but with tremendous dedication, the country is making advances against the disease.

"Historically, a malaria epidemic hits Ethiopia every five to eight years. The last one, in 2003-and four, caught the country unaware. Millions contracted the disease. Nobody knows how many died." Now, "Ethiopia is gearing up for an epic battle with malaria, possibly later this year. The stakes are high, with international aid agencies betting millions of dollars that the Horn of Africa's largest country can wipe out a disease that kills at least a million Africans every year" (Heinlein).

"Malaria is seasonal in Ethiopia coming after the beginning of the rainy season. September and October are usually the months that see the highest number of cases. Will there be more than usual this year? The head of USAID's malaria programme in Ethiopia, Richard Reithinger, says only time will tell, but if it is an epidemic year then some 10 million cases could be expected" (Chinnock). "Aid agencies have spent hundreds of millions of dollars trying to prevent the next outbreak" and "30,000 health extension workers" have been deployed to combat malaria by eradicating mosquitoes and educating the public (Heinlein). "Hospitals are also being put on alert and, meanwhile, the country continues with its ambitious programme to distribute 20 million insecticide-treated bednets" (Chinnock). "In a country with a doctor shortage and a mostly rural population...bednets for all, and an army of village-level health workers are the cornerstones of the strategy to beat the disease" (Heinlein).

The strategy of maintaining village health personnel and distributing anti-mosquito bednets is working for Ethiopia. "In 2005, the Ethiopian government unveiled an ambitious strategy, with donor support, to deliver two mosquito nets to every family at risk. By January 2008, 20.5 million bed nets had been delivered and a third of at-risk children were sleeping in safety... Within three years of the start of the program, cases of malaria, and death rates, had been halved" (Coghlan). With continued support, Ethiopia might just be able to make malaria a disease of the past.

Sources:
Chinnock, Paul. "Ethiopia will expand malaria control efforts." TropIKA.net. 23 Mar 2009.
Coghlan, Nora. "SMART Aid helps Ethiopia halve malaria deaths in two years." ONE International. 12 June 2009.
Heinlein, Peter. Addis Ababa. "Ethiopia Prepares for Battle with Malaria." VOA News. 20 March 2009.
UNICEF Ethiopia. http://www.unicef.org/ethiopia/malaria.html

Malaria in Nigeria

2009-08-13T23:00:00.007-04:00

Fatima (age of 31) has "seen five children into the world." Two of her babies have "died of malaria. When a member of her family falls ill, it is to home remedies and prayer to which Fatima turns. Living in a village in northern Nigeria that is 25 kilometres from the nearest town and without a health clinic or registered drug store, she has little choice" (DFID). [Photo from the DFID]

"Malaria is endemic in Nigeria with about 97% of the population at risk of infection" (Roll). "In Nigeria, malaria causes the deaths of an estimated 250,000 children under the age of five" and a total of 300,000 children every year (UNICEF). In 2007, there were nearly 5.5 million reported cases of malaria in Nigeria (Roll). "Malaria occurs in all parts of Nigeria, including large cities. Transmission is very intense, thus the risk of getting bitten by a malaria-carrying mosquito is very high" (CDC).

"Nigeria, with a population of 148 million, contributes a quarter of the malaria burden in Africa - 50% of the population will have at least one malaria attack each year" (DFID). Many will go unreported and untreated by medical professionals. Clinics are overloaded with the sick and many individuals cannot reach or afford medical help. Still, "malaria is responsible for about 66 per cent of all clinic visits in Nigeria. Health workers are sometimes forced to work overtime, and doctors and nurses can be on duty for over 12 hours a day. Still, women and children have to wait for hours before receiving medical consultation" (UNICEF).

"There is a lot of activity and momentum to combat malaria in Nigeria, but deadly gaps still exist. More needs to be done to prevent children from being infected and ensure access to quality malaria treatment," says Suomi Sakai (UNICEF Representative in Nigeria). Education of the local population "is an important part of UNICEF's malaria prevention work." Doctors and medical personnel must learn "how to prevent, recognize and treat malaria" (UNICEF). Furthermore, everyone needs to know how to properly protect themselves and their families from the mosquitoes that carry the deadly disease.

"However, even when people have been educated about malaria, poverty often stops them from seeking treatment. "Most can't afford the ITNs [Insecticide Treated Nets] or the ACT [Artemisinin-based combination therapy], which cures malaria," says Maryam Hashim (Wandi Primary Health Clinic).

Some level of resistance to malaria may exist in individuals suffering from blood disorders and those who have suffered "repeated attacks of malaria"; however, precautions to avoid mosquito bites should not be overlooked (CDC). Unfortunately, many misconceptions about malaria and its transmission exist. "Persons who were born in Nigeria are NOT protected against malaria, contrary to what many people think" (CDC).

"In 1998, the World Health Organization, UNICEF, the UN Development Programme and the World Bank came together in the Roll Back Malaria partnership, with the goal of halving the global burden of malaria by 2010...One of the objectives of Roll Back Malaria is to reduce malaria-related morbidity and mortality by 50 per cent in Nigeria by 2010, as well as to minimize the socio-economic impact of the disease" (UNICEF). This "intensive campaign" (lasting till December 2010) will distrubte "over 60 million nets...to around 30 million households during the campaign" (DFID). As part of this project, "over 800,000 Long Lasting Insecticide Nets and 55,000 long lasting insecticides kits for the re-treatment of mosquito nets have been procured and distributed by UNICEF in the past three years, with support from the Government of Japan" (UNICEF Nigeria).

Support Roll Back Malaria and its mission to reduce the number of malaria cases in Nigeria. You can also donate to Malaria No More to help provide mosquito nets to families who desperately need them.

Sources:

CDC. Malaria: Nigeria.

DFID [Department for International Development]. Nigeria gears up to roll back malaria.

Roll Back Malaria Partnership. Nigeria.

UNICEF. Nigeria: Together we can fight the scourge of malaria.

UNICEF. "Partnering to roll back malaria in Nigeria's Bauchi State."

Malaria in the UK

2009-08-11T20:49:00.004-04:00

"Prepare for outbreaks of malaria," government agencies warn hospitals in the UK (Prince). Malaria is often considered a minor problem for the UK in modern times, but outbreaks are not unheard of and may become increasingly likely as global warming expands mosquito breeding grounds.

Hospitals must prepare for epidemics as they have been the site of malaria transmission in the past. In 1999 "two patients...contracted malaria while being treated at a hospital in Nottingham." The disease was transmitted from an infected patient in the hospital to the two other patients via a mosquito. That was "the second time there has been an outbreak of the tropical disease in a British hospital" (Malaria).

In 2008 reports of 1370 cases and 6 deaths from malaria were published in the UK (HPA). "A high likelihood of a major heat wave" may lead "to as many as 10,000 deaths, hitting the UK by 2012" warns the government (Prince). In coming years "the UK is to be hit by regular malaria outbreaks, fatal heat waves and contaminated drinking water within five years because of global warming, the Government has warned the NHS [National Health Service]" (Prince).

Malaria has been endemic in the UK before. "Malaria has been seen in these islands in the past" (Prince). "The marshlands of coastal southern and eastern England had unusually high levels of mortality from the sixteenth to the nineteenth century. The unhealthiness of the environment aroused frequent comment during this period and it was attributed to an endemic disease known as "marsh fever" or "ague"." This "marsh fever" is considered to be "malaria transmitted by anopheline mosquitoes. Malaria, once endemic in the coastal marshes of England, had a striking impact on local patterns of disease and death" (Dobson).

Malaria is present in the UK and outbreaks are not impossible. Heat waves from global warming may cause flooding and encourage mosquito breeding, but mosquito havens exist now. "The Thames Estuary has been identified as the likeliest place for a new outbreak of malaria, following an investigation by insect experts" (Thames). An outbreak of malaria may be possible even without the feared heat wave if such mosquito habitats are not addressed effectively.

"A spokesman for the Health Protection Agency said: Our work is based on what is likely to happen if we do nothing to prevent" the development of mosquito breeding grounds, "and it could well be that we see an increase in diseases such as malaria" (Prince).

The idea of a modern malaria epidemic in the UK is horrifying but preventable. "Better management and control of man-made sites where malarial mosquitoes may easily reproduce - such as water wells and bore holes - may help reduce malaria breeding close to human settlements" (Vector). Furthermore, home and land owners should take responsibility to prevent standing and stagnant water on their property. Fountains can be installed into ponds and lakes to agitate the water so that mosquitoes cannot breed. Even small amounts of standing water can serve as a nursery for the mosquitoes that transmit deadly malaria.

Sources:
Dobson MJ. Malaria in England: a geographical and historical perspective. 1994 August.
"Malaria outbreak at UK hospital" BBC. 29 March 1999.
Prince, Rosa. "Malaria Warning as UK becomes warmer." Telegraph.co.uk. 12 Feb 2008.
"Thames marshes 'perfect breeding grounds for malaria'." Evening Standard, The. 1 Feb 2002.
"Vector Control Tools..." The Health and Environment Linkages Initiative. http://www.who.int/heli/risks/vectors/malariacontrol/en/index3.html

Microchip detects malaria in Glasgow

2009-08-07T22:11:00.003-04:00

"Scientists from Glasgow University claim they have created a device which can detect malaria within minutes." A microchip has been created to detect the malaria parasites in a blood sample. After the "blood samples are placed in the microchip" the device detects "the strain of disease. This means the best drug can be used to treat it." This method of detection is much better than previous methods because it is more accurate and faster (BBC).

"The current way of diagnosing is using a blood smear on a slide and examining it on a microscope," said project-leader Dr Ranford-Cartwright. "That will take a good microscopist a good hour to reach a diagnosis, it's extremely difficult to make that diagnosis accurately." This microchip "can give us a result in as little as half an hour."

Although malaria is less prevalent in the UK than in tropical regions of the world, it is not absent. "Last year a study revealed more cases of the most dangerous type of malaria than ever before are being brought back to the UK from trips abroad." Most malaria infections are imported, but the number of detected cases is rising. "The Health Protection Agency study identified 6,753 cases of falciparum malaria diagnosed between 2002 and 2006" (BBC).

Correct diagnosis is only one step toward malaria eradication. Another involves the development and use of effective drugs in the fight against the parasite. Ranford-Cartwright leads several research programs at the University of Glasgow including studies that examine the genetic markers for drug resistance. She says, "For this work we maintain different species of Anopheles mosquitoes in insectaries, and we infect them with P. falciparum sexual stages grown in culture. We use genetic techniques to study complex traits such as the interaction between the malaria parasite and its mosquito vector. We are also involved in work to identify factors important in the spread of anti-malarial resistance" (Ranford-Cartwright). "There is" further "need for a specific, sensitive, robust, and large-scale method for diagnosis of drug resistance genes in natural Plasmodium falciparum infections" (Abdel-Muhsin).

Sources:
Abdel-Muhsin, AM. LC Ranford-Cartwright, et al. "Detection of mutations in the Plasmodium falciparum dihydrofolate reductase (dhfr) gene by dot-blot hybridization." Am. J. Trop. Med. Hyg., 67(1), 2002, pp. 24-27

BBC News. "Doctors welcome Malaria Microchip." 24 April 2009.

Ranford-Cartwright, Lisa. "Research Interests." University of Glasgow. 7 August 2009.

Malaria in Cambodia

2009-08-03T18:35:00.007-04:00

Researchers recently announced that a strain of malaria parasite in Cambodia has become resistant to "arteminisnin-based drugs". This development "could put millions of lives at risk" (Resistance). "Artemisinin-based combination therapies are the recommended first-line treatments of falciparum malaria in all countries with endemic disease. There are recent concerns that the efficacy of such therapies has declined on the Thai-Cambodian border, historically a site of emerging antimalarial-drug resistance" (Dondorp).

"Choloroquine and sulfadoxine-pyrimethamine resistance in P.falciparum emerged in the late 1950s and 1960s on the Thai-Cambodian border and spread across Asia and then Africa, contributing to millions of deaths from malaria. "Since the first reports of chloroquine-resistant falciparum malaria in southeast Asia and South America...drug-resistant malaria has posed a major problem in malaria control. By the late 1980s, resistance to sulfadoxine-pyrimethamine and to mefloquine was also prevalent on the Thai-Cambodian and Thai-Myanmar (Thai-Burmese) borders, rendering them established multidrug-resistant (MDR) areas" (Wongsrichanalai).

"Artemisinins have been available as monotherapies in western Cambodia for more than 30 years, in a variety of forms and doses, whereas in most countries...they have been a relatively recent introduction." An "extended period of often-suboptimal use, and the genetic background of parasites from this region, might have contributed to the emergence and subsequent spread of these new artemisinin-resistant parasites in western Cambodia." "In contrast, artemisinin derivatives have been used almost exclusively in combination with mefloquine on the Thai-Burmese border, where parasitologic responses to artemisinins remain good, even after 15 years of intensive use" (Dondorp).

The recent study compared patients from Cambodia with those from Thailand. "Researchers (Wellcome Trust-Mahidol University Oxford Tropical Medicine Research Program) discovered that on average "patients in Thailand were clear of malaria parasites within 48 hours" but Cambodian patients averaged 84 hours" (Resistance). "These markedly different parasitologic responses were not explained by differences in age" and "adverse events were mild and did not differ significantly between the two treatment groups" (Dondorp). Dr Arjen Dondorp declared, "Our study suggests that malaria parasites in Cambodia are less susceptible to artemisinin than those in Thailand". Currently, artemisinin is used to "clear the parasites at an early stage, preventing them further maturing and reproducing" (Resistance). Since its introduction, "artemisinin-based combination therapies has reduced the morbidity and mortality associated with malaria" (Dondorp).

However, with the new emergence of resistant malaria parasites, the number of malaria related deaths is expected to rise. "Measures for containment are now urgently needed to limit the spread of these parasites from western Cambodia and to prevent a major threat to current plans for eliminating malaria"(Dondorp). "Sixty percent of Cambodia's landscape poses a malarial risk. One million Cambodians are infected with malaria each year" (Wongsrichanalai). "Malaria remains one of the primary causes of mortality in Cambodia... Sustained efforts through local and national malaria control will be necessary to contain Cambodia's malaria epidemic" (Wongsrichanalai).

Image from Donorp. Graph from comparative study between Cambodia and Thailand, and how well the drugs treat malaria.

Sources:
Dondorp AM, Nosten F, Yi P, et al. Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med 2009;361:455-467.
Population Reference Bureau. "Fewer Malaria Cases in Cambodia."
"Resistance to Malaria Drug Reported in Cambodia." US World News. 29 July 2009.
Wongsrichanalai C, Pickard AL, et al. Epidemiology of drug-resistant malaria. 2002 Apr.

Malaria in Bolivia

2009-07-31T08:25:00.001-04:00

Travel websites warn tourists to "consider taking medication for malaria prophylaxis (cholorquine, doxycycline, or mefloquine)," particularly in the areas "surrounding Santa Cruz," where "yellow fever and malaria are two common mosquito-borne diseases" (MDTravel). The CDC indicates that "areas of Bolivia with Malaria" include "all areas <2,500 m" in the regions of "Beni, Chuquisaca, Cochabamba, La Paz, Pando, Santa Cruz, and Tarija." However, the CDC also warns that Chloroquine, commonly used to prevent and treat malaria, "is NOT an effective anti-malaria drug in Bolivia and should not be taken to prevent malaria in this region" (CDC). In reality, "none of the currently available prophylactic medications is 100% effective. If travel to malarious areas is unavoidable, insect protection measures must be strictly followed at all times" (MDTravel).

Furthermore, areas above 2,500 meters are not absent of the disease. "Malaria cases have been reported on the Bolivian high plateau, confirming scientists' predictions that mosquitoes have adapted to a colder climate." These cases "were found in Oruro, western Bolivia, around 3,710 metres above sea level". Researchers have "demonstrated that some anopheles mosquitoes" (the ones that carry malaria) "have adapted to living at altitudes between 2,520 and 3,590 metres--conditions very different from their usual environment: warm, tropical and subtropical regions below 2,600 metres." Some researchers postulate that "a new subspecies has emerged." Scientists have noticed that the tails "have become shorter" and the "mosquito can live in dirty water rather than the clean water it inhabits at lower levels. It can survive" nighttime temperatures "as low as eight degrees Celsius" (Pabon) This can be terrifying news for the residents of these high-altitude regions since many do not have access to adequate health care to combat malaria.

One case study, examines the village of Tuntunani, which is "situated at an elevation of 2,300 meters." This community "experienced its first malaria outbreak in 1998". "An investigation two years later indicated that the epidemic resulted from introduced transmission...58% of the people had been ill for three weeks or longer" as a result. "This outbreak demonstrates the vulnerability of highland populations with poor access to health care to introduced malaria" (Rutar 15).

It seems that malaria is spreading in a country where its effects are already devastating. "Malaria affects over 3.5 million people in Bolivia each year. The Amazon basin regions of Beni and Pando have the country's highest infection rates. In these regions, migratory worker populations, such as castaneros" (Brazil nut farmers) "run a high risk of malaria infection"
When these harvesters "are sick with malaria, the family income drops since workers do not earn their wages and family members stay home to care for them." Estimates indicate that "at least 15,000 families from rural areas depend on this market for survival" (USAID). USAid led a pilot study among the community of Brazil nut harvesters and found that one-third of the farmers tested positive for malaria.

Pregnant women in Bolivia are also at high risk for the disease. Malaria affects pregnant women and children drastically. The anemia and fever from malaria can cause birth defects and death. Furthermore, there is no approved treatment or avoidance measures for pregnant women to take in Bolivia. Many of the prophylactic medications that work against the Bolivian strain of malaria can cause birth defects or miscarriages during the first trimester. At this time, most women find that they can only use mosquito repellent and mosquito nets to avoid contracting malaria during pregnancy.

Map of regions in Bolivia where malaria is endemic

Sources:

CDC.gov/travel/destinations/bolivia.aspx
Pabon, Cristina. Malaria spreading on Bolivian High Plains. SciDevNet.
Rutar, Tina. Eduardo J Baldomar Salgueiro, James H Maguire. "Introduced Plasmodium Vivas Malaria in a Bolivian Community at an Elevation of 2,300 Meters."
TravelMD. Bolivia.
USAID Reducing Malaria in Migrant Populations

Malaria in Russia

2009-07-29T08:05:00.003-04:00

Many people believe that it is impossible to contract malaria in countries that are far away from the tropics. Unfortunately, this is not the case. Even Russia is not immune to the threat of malaria.

"Dozens of people acquire malaria infections in Moscow annually". Most of these cases are "due to people who arrive in the city from southern countries", but surprisingly some people become "infected from home-grown strains of the disease" (Dmitriyev). In 2007, "128 incidents of malaria were registered in Russia. Two of the cases proved fatal. The average annual rate is 100 cases, with the bulk of them occurring in Moscow, Moscow Region and St. Petersburg" (Dmitriyev).

Because malaria is not as prevalent in Russia as it is in tropical regions of the world, "doctors in Russia often lack qualification to diagnose patients" with malaria "and provide the appropriate medical treatment in a timely fashion. Even more often, they fail to determine the exact form of the disease. This may lead to multiple after-effects resulting in the patient's death" (Dmitriyev).

Global climate change threatens to unleash new waves of malaria in Russia. From history, we can see how rises in malaria cases directly corresponds with warm years. For example, "extensive flooding in 1922 resulted in the creation of standing pools of water over wide areas of the upper Volga River basin, which resulted in an explosion of the population of ...mosquitoes" (Packard 7).

"Less than half of all malaria cases in Russia...are caused by guests from tropical countries" (Dmitriyev). Reservoirs, water-logged ditches, and stagnant ponds at parks and recreation areas provide breeding grounds for mosquitoes in Russia. In June of 2008, "the human welfare service successfully eradicated the bulk of the mosquitoes' larvae at several Moscow administrative districts" through regular spraying of these breeding areas (Dmitriyev).

Russia is also contributing to the movement to eradicate malaria worldwide. In 2007, Russia "committed $US 20 MLN to the task" of fighting malaria in Africa. In response, Dr. Brian Chituwa (Zambian Minister of Health) said, "We are confident that this significant contribution will reduce malaria deaths and bring us closer to achieving our millennium development goals" (Russia).

Sources:
Dmitriyev, Sergey. "Malaria Threat." The Moscow News. 24 Jul 2008.

Packard, Randall M. The making of a tropical disease.

"Russia Joins the Fight Against African Malaria." Russia Today. 20 Oct 2007.

Malaria in Ghana

2009-07-24T09:34:00.012-04:00

New Release: 24 July 2009 reports prevalence of fake drugs in Ghana

Despite increased prevention efforts, Ghana is struggling to control endemic Malaria. Major roadblocks include economic deterioration, reduced effectiveness of indoor spraying & bed nets, and the importation of fake drugs to treat malaria.

In early July, US President Obama visited Ghana and "reaffirmed the United States' commitment to fighting malaria and other pressing global health needs" (Malaria Policy, President). For Ghana, the fight against malaria is one of medical and economic concern. "One infected person can indirectly infect 100 others that is how efficient the malaria mosquito is" (Afiriyie). Malaria is detrimental to the population of Ghana and the economic standing of the country. All are effected by the "debilitating effects of malaria on adult victims...In addition to time and money spent on preventing and treating malaria, it causes considerable pain and weakness among its victims. This can reduce peoples' working abilities. The adverse impact of the disease on household production and gross domestic product can be substantial. Malaria therefore is not only a public health problem but also a developmental problem." Apart "from the negative effect of lost productivity on the major sectors of the economy, malaria has negative effects on the growth of tourism, investments and trade especially in endemic regions" (Asante 8).

Every year, "huge sums of money" are "spent on malaria" treatment "even though the disease could be prevented," with the establishment of well-funded programs (Joy). Some methods of malaria control include bed-nets (mosquito nets that drape the beds to prevent mosquito bites during the night) and indoor spraying. Unfortunately, there is some indication that "Indoor Residual Spraying will never eliminate malaria in Ghana". "Hayford Siaw, Executive Director of Volunteer Partnerships for West Africa (VPWA) has expressed concern" over the investments in bed-nets and indoor spraying, saying that "The indoor residual spraying is no more effective than the bed nets, about 25% effective". Effectiveness of indoor treatment is reduced by a "genetic pre-disposition of some malaria mosquitoes" to "only bite outdoors" (Afiriyie). Still, the bed nets and indoor spraying do reduce the number of malaria cases and should not be abandoned. Other methods of eradication should be used in tandem with indoor treatments in order to effectively eliminate malaria in the region.

Ghana is working to establish and maintain programs that will diminish the mosquito population that carries malaria. "Zoomlion, a waste management company that works to improve sanitation throughout the country and fight malaria," maintains "a total of 420 'spraying gangs'" that "periodically spray mosquito breeding sites in order to stop the spread of malaria." This agency "aims to educate communities on sanitation issues and to engage young people in the cause. Their efforts have greatly improved waste issues in the region." (Malaria Policy, Ghana).

The sanitation progress is a step in reducing the "more than 3 million cases of malaria" that "are reported every year in Ghana, more than 900,000 of those cases are young children" (USAID). "45 per cent of child mortality rate recorded nationwide" in 2008 "was caused by malaria" (Joy).

International programs and various governments have stepped up to provide support for Ghana's anti-malaria campaign. It is reported that in December of 2008, China provided "medical assistance to some health practitioners in the country" of Ghana, in order to support their education about anti-malaria practices (Ghana News). In 2006 & 2007, Cuba also donated to Ghana in order to help fund the country's eradication program. Other nations have continuously provided their support to Ghana.

But, news journals have recently revealed that some anti-malarial drugs entering Ghana are fake. "Quantities of a prescription medication used throughout the world for treating malaria have been identified as lacking any active ingredient and presumably counterfeit. These are being removed from the market in Ghana, where they were discovered recently and confirmed as fake last Friday" (Pierson).

The drug (sold as Novartis Coartem{R}) lacked the ingredients necessary to effectively treat malaria. "This drug is an artemisinin-based combination therapy" and it is "recommended by the World Health Organization (WHO) for treating "uncomplicated" malaria" (Pierson).

"It has been estimated that up to 15% of all sold drugs are fake, and in parts of Africa this figure exceeds 50% , which paints a grim picture of health delivery in Ghana and elsewhere in Africa. China is emerging as a source country of counterfeit drugs. India and other Asian countries are" also "emerging as sources"(Ghanian).

"A major barrier in combating malaria throughout much of the developing world is the widespread presence of counterfeit and adulterated drugs, which undermines the public health. Not only do these drugs fail to deliver the appropriate treatment to individual patients--putting their lives at risk, but they contribute to the growth of drug-resistant strains of malaria, one of the greatest challenges to malaria control today" (Pierson).

"The FDB [Food & Drug Board] knows more than anyone that the drug counterfeit business is a multi-million dollar business globally, which is gaining roots in Ghana, the emerging gateway to everything...The production of substandard and fake drugs is a vast and under-reported problem, particularly affecting poorer countries. It is an important cause of unnecessary morbidity, mortality, and loss of public confidence in medicines and health structures" (Ghanian).

"Mr. Anthony Ofori, Brong Ahafo Regional Co-coordinator of Malaria Control," requests "effective collaboration between non-governmental organisations (NGOs), corporate bodies and the health authorities in the campaign against malaria in the country" (Joy). Malaria is endemic throughout the entire country (See map). Ghana is in dire need of positive international assistance in the war against malaria.

Note About Malaria:
"Malaria is integrally tied to maternal and child health in Africa." Each year pregnant women and children suffer and die from the infectious parasite. "Effective malaria control programs" are "vital to helping health systems adequately care for mothers and children," (Malaria Policy, President). "The effect of malaria on people of all ages is quite immense. It is however very serious among pregnant women and children because they have less immunity" (Asante 7).

A Note about Donations:
If you would like to donate to the cause, please visit the Malaria No More site.
At this time, Infectious Bite is not accepting donations. Please donate directly to a reputable agency.

Sources:
Afiriyie, Constance. Volunteer Partnerships for West Africa. "Indoor Residual Spraying will never eliminate malaria in Ghana."

Asante, Felix Ankomah. Kwadwo Asenso-Okyere. Economic Burden of Malaria in Ghana.

Ghanian Journal, The. "Let's do away with fake drugs". 24 July 2009.

Ghana News Agency (via fmprc.gov). China donates anti-malaria drugs to Ghana.

Joy Online. Ghana needs effective collaboration in malaria campaign.

Malaria Policy Center: President Obama Visits Ghana and Reaffirms U.S. Commitment to Fight Malaria.

Malaria Policy Center: Ghana fights malaria by improving sanitation.

Pierson, Francine. US Pharmacopeia. "Counterfeit Antimalarial Drug Discovered in Ghana with Aid of USP Drug Quality and Information Program". 22 July 2009.

USAID Press Release. USAID Administrator Tours Ghana Malaria Control Center.

Halting Malaria Transmission

2009-07-22T23:43:00.005-04:00

Brought to my attention by @sarahsearle

"Researchers at the Johns Hopkins Malaria Research Institute have for the first time produced a malarial protein" that can "generate a significant immune response" and be used to create "a potential transmission-blocking vaccine" (Parsons). Antibodies produced in response to the protein, inhibit the "sexual development of the malaria-causing parasite, Plasmodium, as it grows within the mosquito".

"According to the study, a single-dose vaccine provided a 93 percent transmission-blocking immune response, reaching greater than 98 percent after a booster was given several months later" (Parsons).

Humans are on the verge of successfully creating a vaccine that may inhibit the spread of malaria. In the late 1980s, scientists understood the possibility of transmission-blocking immunity. They discovered that individuals can "develop immunity that suppresses the infectivity of the sexual stages of the parasite." This "immunity is antibody mediated and is directed against the parasites in the mosquito midgut shortly after ingestion of blood by a mosquito." In 1987, scientists declared that "This immunity could be expected to have significant effects on the natural transmission of P. vivax malaria" (Mendis).

"Development of a successful transmission-blocking vaccine is an essential step in efforts to control the global spread of malaria" (Kumar). This study indicates that "it is possible to gradually reduce malaria transmission to a point of almost eradication" (Parsons).

Sources:
Kumar, Nirbhay.

Mendis, K N. Y D Munesinghe, Y N de Silva, I Keragalla, and R Carter. Malaria transmission-blocking immunity induced by natural infections of Plasmodium vivax in humans. 1987 February.

Parsons, Tim. Vaccine Blocks Malaria Transmission in Lab Experiments. 22 July 2009.

Malaria in China

2009-07-19T20:48:00.000-04:00

China has seen a resurgence of Malaria in recent years. "China reported about 24 million malaria cases in the 1970s, the number of cases declined to several hundred thousand by the late 1990s. However, the disease recently has "re-emerged" in China's central and southern provinces, possibly as a result of insufficient prevention work" (Global).

China suffers from Falciparum malaria which "is the most deadly among the four main types of human malaria. Although great success has been achieved since the launch of the National Malaria Control Programme in 1955, malaria remains a serious public health problem in China" (Lin). "Falciparum malaria was endemic in two provinces of China during 2004–05" (Lin). "The 'level one' areas have an annual malaria incidence of more than one case per 10,000 people, while the 'level two' regions have an annual incidence of less than one per 10,000 people" (Global).

Map provided by Travax

"Imported malaria was reported in 26 non-endemic provinces. Annual incidence of falciparum malaria was mapped at county level in the two endemic provinces of China: Yunnan and Hainan. The sex ratio (male vs. female) for the number of cases in Yunnan was 1.6 in the children of 0–15 years and it reached 5.7 in the adults over 15 years of age" (Lin).

The recent resurgence of malaria in China has prompted "China's Ministry of Health" to draft a "plan to eliminate malaria from the country by 2015" (Xinhuanet). "Central and local governments will provide funding for the malaria control programs, an unnamed official from the health ministry's disease control department said." "The plan aims to reduce malaria incidence to less than one case per 10,000 people in high-burden regions and to no cases in low-burden regions between 2010 and 2015" (Global).

Sources:
Global Health Reporting. "Malaria | China Develops Nationwide Malaria Eradication Plan". 10 April 2009.

Lin, Hualiang. Liang Lu, Linwei Tian, Shuisen Zhou, Haixia Wu, Yan Bi, Suzanne C Ho, Qiyong Liu. Spatial and temporal distribution of falciparum malaria in China.

Xinhuanet. "China lays out plans to quell malaria" http://news.xinhuanet.com/english/2009-04/10/content_11163891.htm 10 April 2009.

Malaria in Libya

2009-07-16T23:18:00.000-04:00

Malaria is rare in the desert regions, but Libya has reported some cases of Malaria outbreaks and fears the invasion of mosquitoes carrying the deadly disease.

Map provided by Wikimedia Commons

For the most part, the natural climate of Libya protects it from Malaria outbreak. Libya "is an extremely arid North African country extending southwards from the Mediterranean into the Sahara" (Ramsdale). "Many Libyan oases, like those in other parts of the Sahara, have a history of occasional outbreaks of malaria involving Plasmodium vivax" (Grassi and Feletti) and P. farcipamm (Welch). "The latter species of malaria parasite has been eradicated from the Mediterranean basin but still predominates in Africa south of the Sahara" (Ramsdale).

Although Libya is safe within the Mediterranean basin and sheltered by the Sahara, it is still at risk for malaria. "In Libya, a continuing influx of foreign workers, many from highly malarious parts of the world, ensures the maintenance of a parasite reservoir probably larger than at any time in the past" (Ramsdale). "Malaria was endemic in libya until 1973 where it was declared by WHO to be a country free of malaria" (Kraza). "The situation continued like this until 1976 where there was an epidemic of febrile illness among petroleum company workers ...blood slides of all" cases "were positive for falciparum malaria, reconfirmed in a referral lab" (Kraza). In 2004, cases of malaria were again discovered in Libya. "All cases" were "confirmed microscopically" and were considered "imported, except for one case thought to be introduced" from an imported case (Kraza). The National Center for Infectious Diseases Prevention and Control cites the mission purpose "to prevent reemergence of malaria transmission in the country and to control imported malaria" (Kraza).

The potential for introduction of the fatal malaria parasite is possible in Libya. The feeling of safety against malaria that has developed in Libya in recent years may be dangerous. It is important to remain vigilant in diagnosing new cases and educating the populace about malaria avoidance.

Sources:
Kraza, Ibrahim. "Malaria in Libyan Jamahirya during 2004". National Center For Infectious Diseases Prevention and Control. Damascus 2005.
Ramsdale, C.D. Mosquito Systematics. "Anopheles: Mosquitoes and Imported Malaria in Libya." Vol 22, No.1.
Wikimedia Commons. Location Libya.

Malaria in Mexico

2009-07-14T00:15:00.000-04:00

Mexico is successfully combating the malaria infection and "has made substantial" advances "in decreasing its malaria burden," according to the Center for Disease Control (CDC). There has been no reported death in Mexico attributed to malaria since 1982.

"The risk of Malaria in Mexico low" (Traveldoctor). Infections caused by the most severe form of malaria (P. falciparum) account for less than 1% of cases. Furthermore, the number of reported cases has also dropped significantly in that time. "Between 1985 and 2003, the numbers of reported cases decreased by 97%, to 3,819 cases in 2003" (CDC).

The climate of Mexico yields itself to the spread and breeding of malaria; however, the country has nearly eradicated the disease in many regions. "17 of the country's 32 states have not reported any case of malaria during the past 4 years, and are in the process of being certified as having eliminated malaria" (CDC).

Mexico attributes its success to a strategy of "intensive surveillance". "In such areas, patients and their families are treated repeatedly with antimalarial drugs; breeding sites for mosquito larvae are destroyed or treated; and pyrethroid insecticides are sprayed as needed, inside houses and outdoors" (CDC). Mexico is also taking measures to safeguard the ecosystems, by "introducing new strategies to prevent malaria outbreaks -- without the help of DDT" (IDRC).

Mexico's success inspires other countries in the region to make moves to eradicate malaria within their borders.

Sources:
CDC: Centers for Disease Control and Prevention. "Malaria Nobel Prizes". 26 January 2005.
IDRC Archive. "Controlling Malaria in Mexico Using Alternatives to DDT". 14 September 2001.
TravelDoctor. "Mexico". 13 July 2009.

Malaria in Malawi

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"Malaria is one of Malawi's most serious heath problems" (CDC). The most common malaria found in Malawi is the Plasmodium falciparum, which is "also the most lethal malaria parasite".

The entire population of Malawi is at risk for Malaria, and the highest concern is for children and pregnant women, who are victims of the most severe cases. "In 2001, malaria accounted for 22% of all hospital admissions, 26% of all outpatient visits, and 28% of all hospital deaths. Not all people go to hospitals when sick or having a baby and many die at home, and thus the true numbers are likely much higher" (CDC).

National programs have been established in Malawi to combat malaria. Malawi's National Malaria Control Programme (NMCP) and The National Malaria Technical Committee seek to reduce the cases of malaria in Malawi by using the Roll-back malaria strategy[Website: Roll Back Malaria]. First-line treatment includes the antimalarial drug, sulfadoxine-pyrimethamine, administered as both a medicine and prevention. Insecticide mosquito nets are distributed in Malawi, but their use and spread is limited due to lack of funds. Consquently, 40% of all deaths in this region are considered to be related to malaria (USAID).

Malaria in India

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Ancient records describing malaria have emerged from India. "Details of this disease can be found even in the ancient Indian medical literature like the 'Charaka Samhita'" (Malaria). More recent history has been more tumultuous with crests and falls in numbers of infected individuals.

Since the 1947 epidemic, India has greatly reduced the number of deaths due to Malaria, but the disease is still a threat in many regions. In 2006, there were over 1.04 million documented cases of Malaria, with 890 ending in death. Resurgences of the disease were seen during the 1970s due to DDT shortages, and in the 1990s due to the emergence of mosquitoes that were resistant to insecticide. During the periods "of resurgence of malaria, certain states of the Union of India like Uttar Pradesh, Bihar, Karnataka, Orissa, Rajasthan, Madhya Pradesh and Pondichery are found to be worst affected" (Malaria). In the 1990s, malaria was considered "endemic in all of India except at elevations above 1800 meters and in some coastal areas" (Sharma, 1996a). However, "the total number of cases of malaria in India has stabilized somewhat over the past ten years" (Brown).

Some accuse the local and national governments of failing to report the correct number of malaria cases and assert that the actual severity of malaria in India is much greater than it appears. "India has always under-reported its malaria cases, government officials admit off the record. But the scope of the hidden problem has become astounding. While the official figures state that in 2008 India had 1.5 million malaria cases, resulting in 924 deaths, the real number of deaths is higher by several orders of magnitude" (Neelakantan). While 924 deaths from malaria were reported last year, some accusers claim that the "real number of malaria-related deaths in India was closer to 40,000 in 2008." The assertions are made by various non-governmental sources and some government officials who didn't want to be named. Since these sources prefer to remain anonymous, no conclusive evidence can be derived. Regardless, these statements may lead to further questioning and investigation in anti-malaria programs within India.

All visitors to India should note that malaria does "occur in most parts of India (including large cities). According to the World Health Organization, every year in India an estimated 2 million cases of malaria occur, with 1,000 deaths; and 95% of the population live in malaria-risk areas" (CDC.gov).

The Threat of Drug Resistant Malaria

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Recent tests indicate that the most common malaria strains are becoming resistant to combination treatments in vulnerable areas. "Selected trials" showed "high failure rates for some combinations" of medicines. Anti-malarial treatments must be questioned, particularly in susceptible regions (Wiley).

The most common type of malaria parasite causes uncomplicated malaria, which is a mild form of the disease. However, if this strain remains untreated, it can develop into a life-threatening condition. "Resistance" of this strain "to the older antimalarials has led the WHO to recommend treatments combining" a fast-acting drug with a "longer-lasting drug to combat resistance."

Malaria can be a difficult disease to cure and is most often treated with a combination of medicines. During the recent tests, "there were examples of treatment failure rates above 10% for all evaluated combinations." According to the WHO, this exceeds the "maximum allowable failure rate for a first line antimalarial" treatment.

A recently introduced drug, dihydroartemisinin-piperaquine, performed well when compared to the standard treatment of artemisinin-based combination therapies (ACTs). This new treatment "offers another potential first-line therapy for the disease".

"Patterns of resistance change from place to place and over time," so continued testing of infected individuals and monitoring of progress is necessary to ensure successful treatment. These research and medical programs are costly, and severely underfunded. If you would like to contribute money to malaria research, please visit the following sites.

Anti-malaria agencies:

Roll Back Malaria Partnership: Index of non-profit organizations that fight malaria (and need donations)
United Nations Foundation: With your donation you are helping us expand the worldwide fight against disease, poverty, climate change, and conflict

(Infectious bite is not currently accepting donations. Please see the appropriate agencies for information on donations)

Source:
Wiley-Blackwell. "Continued Vigilance Against Drug-resistance Malaria Is Needed." ScienceDaily 7 July 2009. 9 July 2009 < http://www.sciencedaily.com /releases/2009/07/090707201209.htm >.